Provider Demographics
NPI:1770834830
Name:ORANGE COUNTY IMAGING SPECIALISTS
Entity Type:Organization
Organization Name:ORANGE COUNTY IMAGING SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHROKNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-859-0400
Mailing Address - Street 1:27758 SANTA MARGARITA PKWY
Mailing Address - Street 2:#285
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6709
Mailing Address - Country:US
Mailing Address - Phone:949-859-0400
Mailing Address - Fax:949-269-9139
Practice Address - Street 1:1001 N TUSTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3502
Practice Address - Country:US
Practice Address - Phone:949-583-9264
Practice Address - Fax:949-269-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67310261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology