Provider Demographics
NPI:1881966778
Name:CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC
Entity type:Organization
Organization Name:CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-841-5200
Mailing Address - Street 1:3610 W PACKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-5010
Mailing Address - Country:US
Mailing Address - Phone:559-713-6050
Mailing Address - Fax:
Practice Address - Street 1:462 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3321
Practice Address - Country:US
Practice Address - Phone:209-577-9900
Practice Address - Fax:209-577-9900
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA MEDICAL IMAGING ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-07
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QM1200X
261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)