Provider Demographics
NPI:1740330331
Name:MAGNETIC IMAGING SERVICES, INC.
Entity type:Organization
Organization Name:MAGNETIC IMAGING SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP. COO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:I
Authorized Official - Credentials:BA, MBA
Authorized Official - Phone:714-736-9400
Mailing Address - Street 1:6281 BEACH BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-4221
Mailing Address - Country:US
Mailing Address - Phone:714-736-9400
Mailing Address - Fax:714-736-9494
Practice Address - Street 1:6281 BEACH BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-4221
Practice Address - Country:US
Practice Address - Phone:714-736-9400
Practice Address - Fax:714-736-9494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization