Provider Demographics
NPI:1184904518
Name:MEDPIXELS MEDICAL SERVICES, PC
Entity type:Organization
Organization Name:MEDPIXELS MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VENKATRAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-646-2702
Mailing Address - Street 1:10053 BRET AVE
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3518
Mailing Address - Country:US
Mailing Address - Phone:408-646-2702
Mailing Address - Fax:408-725-8561
Practice Address - Street 1:2211 MOORPARK AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2663
Practice Address - Country:US
Practice Address - Phone:408-646-2702
Practice Address - Fax:408-725-8561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97250261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology