Provider Demographics
NPI:1669432019
Name:MAGNETIC IMAGING MEDICAL GROUP, INC
Entity type:Organization
Organization Name:MAGNETIC IMAGING MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-498-6322
Mailing Address - Street 1:8515 FLORENCE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90240-4043
Mailing Address - Country:US
Mailing Address - Phone:562-904-1340
Mailing Address - Fax:562-869-8606
Practice Address - Street 1:8515 FLORENCE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-4043
Practice Address - Country:US
Practice Address - Phone:562-904-1340
Practice Address - Fax:562-869-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW8970Medicare PIN