Provider Demographics
NPI:1932419090
Name:ULTRASOUND INSTITUTE MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ULTRASOUND INSTITUTE MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-497-3572
Mailing Address - Street 1:740 E. HIGHLAND AVE.
Mailing Address - Street 2:SUITE. 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3649
Mailing Address - Country:US
Mailing Address - Phone:602-354-4333
Mailing Address - Fax:602-354-8191
Practice Address - Street 1:740 E. HIGHLAND AVE.
Practice Address - Street 2:SUITE. 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-3649
Practice Address - Country:US
Practice Address - Phone:602-354-4333
Practice Address - Fax:602-354-8191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty