Sports Imaging, LLC

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

License

42368 Issued in CA

Legal business name

SPORTS IMAGING, LLC

Practice address

2675 Stevenson Blvd
Fremont, CA 94538-2323

Phone

(510) 795-6534

Fax

(510) 794-6822

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

John Mazoros

Title

Administrator

Phone

(510) 456-4600

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1346329901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR STE 280",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-456-4650",
            "fax_number": "510-456-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 STEVENSON BLVD",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382323",
            "telephone_number": "510-795-6534",
            "fax_number": "510-794-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "MAZOROS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "510-456-4600"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "CA",
            "license": "42368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Sentell Spears, M.D.
• Valerie Spier, RD
• Thomas Gerard Spillner, D.D.S.
• Giancarlo Sponzilli
• Sport Clinic Inc
• Julie Marie Sprague-McRae, PNP
• Blake Spurlock
• Nicholas Squires, MD
• Kirandeep Kaur Sran, FNP
• Gayathri Sridhar

• Magnetic Resonance Imaging Radiologic Technologist in Fremont, CA
• Providers in Fremont, CA by specialty
• Magnetic Resonance Imaging Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; 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.