NPIMap

Organization Active NPI

Mink Radiologic Imaging Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Beverly Hills, CA
National Provider Identifier
1265485015
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MINK RADIOLOGIC IMAGING MEDICAL ASSOCIATES, INC.
Practice address
8670 Wilshire Blvd Ste 101
Suite 101
Beverly Hills, CA 90211-2930
Phone
(310) 358-2100
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Authorized official

Name
Jerrold Mink, M.D.NPI 1619925971
Title
Medical Director
Phone
(310) 358-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

8670 Wilshire Blvd Ste 101
Suite 101
Beverly Hills, CA 90211-2930

Mailing address

PO Box 190
Simi Valley, CA 93062-0190
Phone (805) 522-5940

Other identifiers 4

IdentifierTypeStateIssuer
ZZZ06391ZOtherBLUE SHIELD
ZZZ66023ZOtherBLUE SHIELD
DA6633OtherRAILROAD MEDICARE
ZZZ77048ZOtherBLUE SHIELD

National Provider Directory

National Provider Directory

Locations

2080 Century Park E
Ste 1204
Los Angeles, CA 90067
Phone (310) 430-1310

13160 Mindanao Way
Ste 213
Marina del Rey, CA 90292

13160 Mindanao Way
Ste 175
Marina del Rey, CA 90292
Phone (310) 305-4500

2428 Santa Monica Blvd
Ste 101
Santa Monica, CA 90404
Phone (310) 315-1000

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 42

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": "1381190400000",
    "number": "1265485015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930620190",
            "telephone_number": "805-522-5940",
            "fax_number": "805-522-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8670 WILSHIRE BLVD STE 101",
            "address_2": "SUITE 101",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112930",
            "telephone_number": "310-358-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINK RADIOLOGIC IMAGING MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-10-08",
        "status": "A",
        "authorized_official_last_name": "MINK",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-358-2100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ06391Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ66023Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA6633",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ77048Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.