Provider Demographics
NPI:1982848214
Name:INNERSCOPE IMAGING NETWORK
Entity Type:Organization
Organization Name:INNERSCOPE IMAGING NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GLORIA SCEBERRAS
Authorized Official - Prefix:MISS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCEBBERAS
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:714-892-8898
Mailing Address - Street 1:PO BOX 3414
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-8414
Mailing Address - Country:US
Mailing Address - Phone:714-892-8898
Mailing Address - Fax:714-892-1819
Practice Address - Street 1:7631 WYOMING ST
Practice Address - Street 2:SUITE 103-A
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-3904
Practice Address - Country:US
Practice Address - Phone:714-892-8898
Practice Address - Fax:714-892-1819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC423482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty