Advanced Cardiac Imaging Corporation
Organization Active NPI Radiology Clinic/Center · Downey, CA
NPI 1013961630 · NPPES record last updated Oct 31, 2012
Key facts
- NPI
- 1013961630
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Radiology Clinic/Center 261QR0200X
- Legal business name
- ADVANCED CARDIAC IMAGING CORPORATION
- Practice address
- 12632 Bellflower Blvd
Downey, CA 90242-4812 - Phone
- (562) 401-0189
- Fax
- (562) 401-0160
- NPI assigned
- May 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Emma Sevilleno Bodota, ARMDS
- Title
- President
- Phone
- (562) 401-0189
Practitioners 3
-
Ruby Elaine Calalo, AGACNP-BC
-
William Kenneth Halliday, M.D.
-
Milan Gaurang Rawal, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040721001257 | CA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 7517947476 | Practice locations: Downey, CA |
National Provider Directory
Locations
12632 Bellflower Blvd
Downey, CA 90242
Phone (562) 400-0189
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Yes |
Addresses
Primary practice location
12632 Bellflower Blvd
Downey, CA 90242-4812
Mailing address
12632 Bellflower Blvd
Downey, CA 90242-4812
Phone (562) 401-0189
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IDTF00390 | Medicaid | CA |
Other providers in Downey, CA
- Adapthealth West, LLC
- Edilberto Adaya
- Christa S Adeyemi
- Mark Ferdinand Adriatico
- Advanced Anesthesia Medical Corp
- Leslie Aedo
- Gary Afferino
- Patrocinia Afkari
- Sohail Afra
- Richy Agajanian
All providers in Downey, CA · Radiology Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.