Provider Demographics
NPI:1881861359
Name:NEXT IMAGE MEDICAL, INC.
Entity Type:Organization
Organization Name:NEXT IMAGE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-847-9185
Mailing Address - Street 1:3398 CARMEL MOUNTAIN RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1044
Mailing Address - Country:US
Mailing Address - Phone:858-274-9185
Mailing Address - Fax:858-847-9135
Practice Address - Street 1:3398 CARMEL MOUNTAIN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1044
Practice Address - Country:US
Practice Address - Phone:858-274-9185
Practice Address - Fax:858-847-9135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)