NPIMap

Organization Active NPI

Souk Luangsrinhotha Modesto Mobile Imaging Services

Doing business as Modesto Mobile Imaging Services

  • Sonography Radiologic Technologist
  • Salida, CA
National Provider Identifier
1548810336
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sonography Radiologic TechnologistTaxonomy code 2471S1302X
Legal business name
SOUK LUANGSRINHOTHA MODESTO MOBILE IMAGING SERVICES
Doing business as
Modesto Mobile Imaging Services
Practice address
5021 Rosso CT
Salida, CA 95368-9066
Phone
(209) 855-6900
NPI assigned
Sep 13, 2019
Last updated
Sep 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Authorized official

Name
Souk Luangsrinhotha, R.T(R)(CT)(ARRT)NPI 1972090652
Title
Owner
Phone
(209) 855-6900

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
Sonography Radiologic Technologist 2471S1302X NU Primary

Addresses

Primary practice location

5021 Rosso CT
Salida, CA 95368-9066

Mailing address

PO Box 3091
Modesto, CA 95353-3091
Phone (209) 575-4575

Other identifiers 1

IdentifierTypeStateIssuer
1972090652MedicaidCA

Other names 1

  • MODESTO MOBILE IMAGING SERVICES Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568332800000",
    "number": "1548810336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3091",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953533091",
            "telephone_number": "209-575-4575",
            "fax_number": "209-575-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5021 ROSSO CT",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "953689066",
            "telephone_number": "209-855-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUK LUANGSRINHOTHA MODESTO MOBILE IMAGING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A",
        "authorized_official_last_name": "LUANGSRINHOTHA",
        "authorized_official_first_name": "SOUK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-855-6900",
        "authorized_official_credential": "R.T(R)(CT)(ARRT)"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972090652",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODESTO MOBILE IMAGING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salida, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.