Moreno Valley Imaging, L.L.C.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MORENO VALLEY IMAGING, L.L.C.

Practice address

12818 Heacock St
Suite C2
Moreno Valley, CA 92553-3173

Phone

(951) 242-2508

Fax

(951) 242-2548

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brian Hennebry

Title

Cfo

Phone

(951) 242-2508

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508924796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12818 HEACOCK ST",
            "address_2": "SUITE C2",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533173",
            "telephone_number": "951-242-2508",
            "fax_number": "951-242-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 HEACOCK ST",
            "address_2": "SUITE C2",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925533173",
            "telephone_number": "951-242-2508",
            "fax_number": "951-242-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORENO VALLEY IMAGING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENNEBRY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "951-242-2508",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moreno Valley CMHC
• Moreno Valley Community Hospital
• Moreno Valley Community Medical Group
• Moreno Valley Dental Center
• Moreno Valley Dialysis Center
• Moreno Valley Med Care LLC
• Moreno Valley Medical Group, Inc
• Moreno Valley Physicians Associates, a Medical Corp
• Moreno Valley Regional Dialysis
• Moreno Valley SL I Limited Partnership

• Physiological Laboratory in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Physiological Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.