Provider Demographics
NPI:1811267784
Name:BREAST IMAGING SPECIALISTS, INC
Entity type:Organization
Organization Name:BREAST IMAGING SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DIPA
Authorized Official - Middle Name:HARISH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-245-0729
Mailing Address - Street 1:15195 NATIONAL AVE
Mailing Address - Street 2:SUITE201
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2631
Mailing Address - Country:US
Mailing Address - Phone:925-245-0729
Mailing Address - Fax:
Practice Address - Street 1:15195 NATIONAL AVE
Practice Address - Street 2:SUITE201
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2631
Practice Address - Country:US
Practice Address - Phone:925-245-0729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51518261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography