Provider Demographics
NPI:1760492458
Name:ALLIANCE HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ALLIANCE HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC VP &CFO
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:AIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-544-3215
Mailing Address - Street 1:100 BAYVIEW CIRCLE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2984
Mailing Address - Country:US
Mailing Address - Phone:800-544-3215
Mailing Address - Fax:
Practice Address - Street 1:210 W SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1515
Practice Address - Country:US
Practice Address - Phone:626-331-7331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2014-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA470000284OtherRAILROAD MEDICARE
CAZZZ00506ZOtherBLUE SHIELD
CAIDTF00460Medicaid
CA470001394OtherRAILROAD MEDICARE
CAZZZ00504ZOtherBLUE SHIELD
CAZZZ00504ZOtherBLUE SHIELD