Organization Active NPI

Sunnyvale Imaging Center a Professional Medical Corporation

  • Radiology Clinic/Center
  • Sunnyvale, CA
National Provider Identifier
1619407111
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SUNNYVALE IMAGING CENTER A PROFESSIONAL MEDICAL CORPORATION
Practice address
568 S Mathilda Ave
Sunnyvale, CA 94086-7607
Phone
(408) 738-0232
Fax
(408) 738-0242
NPI assigned
Jun 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Teresa Perez
Title
Credentialing Administrator
Phone
(209) 261-7905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X CA Primary

Addresses

Primary practice location

568 S Mathilda Ave
Sunnyvale, CA 94086-7607

Mailing address

568 S Mathilda Ave
Sunnyvale, CA 94086-7607
Phone (408) 738-0232

National Provider Directory

National Provider Directory

Locations

568 S Mathilda Ave
Sunnyvale, CA 94086
Phone (310) 739-0424

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1497571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1619407111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 S MATHILDA AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940867607",
            "telephone_number": "408-738-0232",
            "fax_number": "408-738-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 S MATHILDA AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940867607",
            "telephone_number": "408-738-0232",
            "fax_number": "408-738-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYVALE IMAGING CENTER A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-16",
        "last_updated": "2022-07-21",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
        "authorized_official_telephone_number": "209-261-7905"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.