Provider Demographics
NPI:1811233521
Name:OPEN MRI OF FREMONT
Entity Type:Organization
Organization Name:OPEN MRI OF FREMONT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BASIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:BESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-585-2295
Mailing Address - Street 1:39180 FARWELL DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39180 FARWELL DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1000
Practice Address - Country:US
Practice Address - Phone:510-585-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)