Provider Demographics
NPI:1336164284
Name:OPEN ADVANTAGE MRI II
Entity Type:Organization
Organization Name:OPEN ADVANTAGE MRI II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-200-2232
Mailing Address - Street 1:600 N TUSTIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3736
Mailing Address - Country:US
Mailing Address - Phone:714-479-0400
Mailing Address - Fax:714-919-0350
Practice Address - Street 1:600 N TUSTIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3736
Practice Address - Country:US
Practice Address - Phone:714-479-0400
Practice Address - Fax:714-919-0350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATD054Medicare ID - Type Unspecified