Provider Demographics
NPI:1881646909
Name:CALIFORNIA ADVANCED IMAGING MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:CALIFORNIA ADVANCED IMAGING MEDICAL ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AVANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMBEKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-308-4890
Mailing Address - Street 1:PO BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-3404
Mailing Address - Fax:
Practice Address - Street 1:1101 VAN NESS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6919
Practice Address - Country:US
Practice Address - Phone:415-600-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA169891OtherBLUESHIELD OF CA
CA801255754Medicaid
CA801255780Medicaid
CA101349561Medicaid
CA801255740Medicaid
CA801255778Medicaid
NE10025574200Medicaid
OK200745170AMedicaid
CA101206065Medicaid
CA801255747Medicaid
CA100338889Medicaid
CA801255782Medicaid
CA801255774Medicaid
IA1255530606Medicaid
CA800348694Medicaid
CA801255779Medicaid
CA347104OtherANTHEM BLUE CROSS
CA379577200OtherDEPARTMENT OF LABOR