Active NPI
Advanced Cardiac Imaging Corporation
- Radiology Clinic/Center
- Downey, CA
National Provider Identifier
1013961630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- 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
- Last updated
- Oct 31, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Emma Sevilleno Bodota, ARMDS
- Title
- President
- Phone
- (562) 401-0189
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | Primary |
Addresses
Primary practice location
12632 Bellflower Blvd
Downey, CA 90242-4812
Mailing address
12632 Bellflower Blvd
Downey, CA 90242-4812
Phone (562) 401-0189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| 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
National Provider DirectoryLocations
12632 Bellflower Blvd
Downey, CA 90242
Phone (562) 400-0189
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Acute Care Nurse Practitioner
- Los Alamitos, CA
- NPI 1043915440
-
- Cardiovascular Disease Physician
- Montebello, CA
- NPI 1013021708
-
- Cardiovascular Disease Physician
- Lakewood, CA
- NPI 1093913147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1351641600000",
"number": "1013961630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12632 BELLFLOWER BLVD",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902424812",
"telephone_number": "562-401-0189",
"fax_number": "562-401-0160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12632 BELLFLOWER BLVD",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902424812",
"telephone_number": "562-401-0189",
"fax_number": "562-401-0160"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED CARDIAC IMAGING CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2012-10-31",
"status": "A",
"authorized_official_last_name": "BODOTA",
"authorized_official_first_name": "EMMA",
"authorized_official_middle_name": "SEVILLENO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "562-401-0189",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "ARMDS"
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.