Provider Demographics
NPI:1689635930
Name:ESCONDIDO IMAGING CENTER
Entity Type:Organization
Organization Name:ESCONDIDO IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RABBE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LINDSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-480-6519
Mailing Address - Street 1:PO BOX 460398
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92046-0398
Mailing Address - Country:US
Mailing Address - Phone:760-520-8500
Mailing Address - Fax:760-520-8523
Practice Address - Street 1:355 E GRAND AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3313
Practice Address - Country:US
Practice Address - Phone:760-480-6519
Practice Address - Fax:760-480-1012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA149423261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATP087Medicare PIN
P00087021Medicare PIN