Provider Demographics
NPI:1760774723
Name:SHARP AND CHILDREN'S MRI CENTER LLC
Entity Type:Organization
Organization Name:SHARP AND CHILDREN'S MRI CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:858-565-0950
Mailing Address - Street 1:PO BOX 23326
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-3326
Mailing Address - Country:US
Mailing Address - Phone:858-565-0950
Mailing Address - Fax:858-565-2863
Practice Address - Street 1:3010 CHILDRENS WAY
Practice Address - Street 2:SUITE LL220
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-939-4550
Practice Address - Fax:858-939-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)