Provider Demographics
NPI:1750522132
Name:NORTH VALLEY ADVANCED IMAGING, LLC
Entity type:Organization
Organization Name:NORTH VALLEY ADVANCED IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-898-0504
Mailing Address - Street 1:1720 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3315
Mailing Address - Country:US
Mailing Address - Phone:530-898-0504
Mailing Address - Fax:530-898-9647
Practice Address - Street 1:1638 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3313
Practice Address - Country:US
Practice Address - Phone:530-345-6067
Practice Address - Fax:530-345-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty