Provider Demographics
NPI:1952758849
Name:INNOVATIVE MINIMALLY INVASIVE IMAGING & THERAPEUTICS, INC
Entity Type:Organization
Organization Name:INNOVATIVE MINIMALLY INVASIVE IMAGING & THERAPEUTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MALWINDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:SINGHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-575-0308
Mailing Address - Street 1:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91102-0379
Mailing Address - Country:US
Mailing Address - Phone:401-575-0308
Mailing Address - Fax:562-548-7540
Practice Address - Street 1:8283 GROVE AVE STE 207A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3141
Practice Address - Country:US
Practice Address - Phone:401-575-0308
Practice Address - Fax:562-548-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA928152085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty