Provider Demographics
NPI:1861668709
Name:MONARCH IMAGING
Entity Type:Organization
Organization Name:MONARCH IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CANDUS
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC/SLP
Authorized Official - Phone:915-433-2565
Mailing Address - Street 1:6206 ESCONDIDO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1929
Mailing Address - Country:US
Mailing Address - Phone:915-433-2565
Mailing Address - Fax:
Practice Address - Street 1:6206 ESCONDIDO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1929
Practice Address - Country:US
Practice Address - Phone:915-433-2565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile