Pro-Life Imaging LLC

Primary specialty

Mobile Mammography Clinic/CenterTaxonomy code 261QR0207X

Legal business name

PRO-LIFE IMAGING LLC

Practice address

3411 Johnston Ave
Redondo Beach, CA 90278-1522

Phone

(661) 713-8720

Fax

(855) 940-1565

NPI assigned

Apr 19, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Griselda M Lougedo, CRT

Title

Ceo

Phone

(661) 713-8720

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1003503137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 N PARAMOUNT BLVD",
            "address_2": "UNIT 133",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90805",
            "telephone_number": "661-713-8720",
            "fax_number": "855-940-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 JOHNSTON AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902781522",
            "telephone_number": "661-713-8720",
            "fax_number": "855-940-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-LIFE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "LOUGEDO",
        "authorized_official_first_name": "GRISELDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-713-8720",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "261QR0207X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.