Provider Demographics
NPI:1821236910
Name:REGIONAL MEDICAL SERVICES
Entity Type:Organization
Organization Name:REGIONAL MEDICAL SERVICES
Other - Org Name:REGIONAL IMAGING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRALLEGRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-238-1155
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-0104
Mailing Address - Country:US
Mailing Address - Phone:714-238-1155
Mailing Address - Fax:
Practice Address - Street 1:559 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4241
Practice Address - Country:US
Practice Address - Phone:714-238-1155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)Group - Single Specialty