Provider Demographics
NPI:1245499201
Name:A1 IMAGING OF VENICE LLC
Entity type:Organization
Organization Name:A1 IMAGING OF VENICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BABITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-336-4336
Mailing Address - Street 1:100 BAYVIEW CIR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2983
Mailing Address - Country:US
Mailing Address - Phone:949-336-4336
Mailing Address - Fax:949-336-4346
Practice Address - Street 1:1370 E VENICE AVE
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-9082
Practice Address - Country:US
Practice Address - Phone:941-485-6736
Practice Address - Fax:941-483-3211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A1 IMAGING CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-05
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)