Provider Demographics
NPI:1952345290
Name:MEDICAL IMAGING ASSOCIATES
Entity Type:Organization
Organization Name:MEDICAL IMAGING ASSOCIATES
Other - Org Name:BEVERLY HILLS DIAGNOSTIC BREAST CENTER MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:PRITCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-278-0656
Mailing Address - Street 1:9033 WILSHIRE BLVD
Mailing Address - Street 2:305
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1837
Mailing Address - Country:US
Mailing Address - Phone:310-278-0656
Mailing Address - Fax:310-278-7716
Practice Address - Street 1:9033 WILSHIRE BLVD
Practice Address - Street 2:305
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1837
Practice Address - Country:US
Practice Address - Phone:310-278-0656
Practice Address - Fax:310-278-7716
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES H. PRITCHARD, M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-16
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC321682085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY48678YMedicaid
CAW1408Medicare ID - Type Unspecified