Provider Demographics
NPI:1689628679
Name:CALIFORNIA ADVANCED IMAGING MEDICAL ASSOC., INC.
Entity Type:Organization
Organization Name:CALIFORNIA ADVANCED IMAGING MEDICAL ASSOC., INC.
Other - Org Name:NATIONAL ORTHOPEDIC IMAGING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:HOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-884-3448
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3418
Mailing Address - Fax:415-883-3406
Practice Address - Street 1:1260 S ELISEO DR STE 101
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2009
Practice Address - Country:US
Practice Address - Phone:415-464-8080
Practice Address - Fax:415-461-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0003144Medicaid
CACI2439OtherRAILROAD MEDICARE
CAGR0003144Medicaid