Provider Demographics
NPI:1649483553
Name:ORANGE COUNTY SPINAL IMAGING INC
Entity type:Organization
Organization Name:ORANGE COUNTY SPINAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONOGHUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-538-4088
Mailing Address - Street 1:3145 E ABBEY LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2009
Mailing Address - Country:US
Mailing Address - Phone:949-552-7246
Mailing Address - Fax:
Practice Address - Street 1:3145 E ABBEY LN
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-2009
Practice Address - Country:US
Practice Address - Phone:949-552-7246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHC1477192471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty