Provider Demographics
NPI:1942236443
Name:QUEST IMAGING MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:QUEST IMAGING MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-633-5000
Mailing Address - Street 1:PO BOX 2447
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-2447
Mailing Address - Country:US
Mailing Address - Phone:661-633-5000
Mailing Address - Fax:661-633-2500
Practice Address - Street 1:9602 STOCKDALE HWY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3618
Practice Address - Country:US
Practice Address - Phone:661-633-5000
Practice Address - Fax:661-633-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0600058910261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0092570Medicaid
CAGR0092570Medicaid
CACK5631Medicare ID - Type UnspecifiedRAILROAD MEDICARE GRP #