Provider Demographics
NPI:1932375250
Name:THE WOMANS IMAGE
Entity Type:Organization
Organization Name:THE WOMANS IMAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-947-7100
Mailing Address - Street 1:41210 11TH ST W
Mailing Address - Street 2:SUITE K
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-1447
Mailing Address - Country:US
Mailing Address - Phone:661-947-7100
Mailing Address - Fax:661-947-7670
Practice Address - Street 1:39409 10TH ST W
Practice Address - Street 2:SUITE B
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3781
Practice Address - Country:US
Practice Address - Phone:661-947-2229
Practice Address - Fax:661-947-3395
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARRISON FAMILY MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty