Wave Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

WAVE IMAGING, LLC

Doing business as

Memorialcare Imaging Center-Fountain Valley

Practice address

18785 Brookhurst St
Suite 102
Fountain Valley, CA 92708

Phone

(714) 417-9950

Fax

(714) 417-9970

NPI assigned

Apr 14, 2015

Last updated

Apr 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark D Schafer, M.D.

Title

Manager

Phone

(657) 241-3500

Specialties & licenses 1

Addresses

Other names 1

• MEMORIALCARE IMAGING CENTER-FOUNTAIN VALLEY Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430092800000",
    "number": "1538555735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "657-241-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18785 BROOKHURST ST",
            "address_2": "SUITE 102",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "92708",
            "telephone_number": "714-417-9950",
            "fax_number": "714-417-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2015-04-27",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "657-241-3500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEMORIALCARE IMAGING CENTER-FOUNTAIN VALLEY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fritzi Washington
• Wasim H Raja MD
• Elizabeth Grace Watson
• Shanelle Watson
• Michael Watts, PHARM.D
• Waves of Peace, an Individual and Family Counseling Corporation (Waves of Peace Counseling Services)
• Matthew Morichetti Weaver, BT
• Mary Webb
• Patricia R Weber
• Richard R Weber, PHD

• Radiology Clinic/Center in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.