Provider Demographics
NPI:1780634576
Name:IMAGING ASSOCIATES OF PORTERVILLE
Entity Type:Organization
Organization Name:IMAGING ASSOCIATES OF PORTERVILLE
Other - Org Name:NARIN SIRIBHADRA M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRIBHADRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-782-1065
Mailing Address - Street 1:PO BOX 1866
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93258-1866
Mailing Address - Country:US
Mailing Address - Phone:559-782-1065
Mailing Address - Fax:559-791-0166
Practice Address - Street 1:811 W MORTON AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3131
Practice Address - Country:US
Practice Address - Phone:559-782-1065
Practice Address - Fax:559-791-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ67018ZOtherBLUE SHIELD PROVIDER NUMB
CA1780634576Medicaid
CA1780634576Medicare NSC