Provider Demographics
NPI:1942509211
Name:PRECISION OPEN MRI
Entity Type:Organization
Organization Name:PRECISION OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RANTIADE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTULANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-846-5888
Mailing Address - Street 1:PO BOX 1532
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-0153
Mailing Address - Country:US
Mailing Address - Phone:925-846-5888
Mailing Address - Fax:925-461-0470
Practice Address - Street 1:1393 SANTA RITA RD
Practice Address - Street 2:STE D
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-5665
Practice Address - Country:US
Practice Address - Phone:925-846-5888
Practice Address - Fax:925-461-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)