Provider Demographics
NPI:1891946497
Name:ALDRIC J SHIM MD INC
Entity Type:Organization
Organization Name:ALDRIC J SHIM MD INC
Other - Org Name:OLYMPIC MEDICAL IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-618-4567
Mailing Address - Street 1:1066 RIDGESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3729
Mailing Address - Country:US
Mailing Address - Phone:310-618-4567
Mailing Address - Fax:
Practice Address - Street 1:2727 W OLYMPIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2641
Practice Address - Country:US
Practice Address - Phone:213-381-0910
Practice Address - Fax:213-381-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77053261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)