Provider Demographics
NPI:1740964097
Name:RED SEA MEDICAL IMAGING INC
Entity type:Organization
Organization Name:RED SEA MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAHASAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-277-5617
Mailing Address - Street 1:PO BOX 88628
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90009-8628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14739 RICHVALE DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1036
Practice Address - Country:US
Practice Address - Phone:562-277-5617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology