Modesto Mobile Imaging Services

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

MODESTO MOBILE IMAGING SERVICES

Practice address

5021 Rosso CT
Salida, CA 95368-9066

Phone

(209) 855-6900

NPI assigned

Sep 26, 2019

Last updated

Sep 26, 2019By 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

Jamie Dole

Title

Manager

Phone

(209) 575-4575

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Practitioners 2

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.

• Souk Luangsrinhotha

  • Radiologic Technologist
  • Salida, CA
  • NPI 1972090652
  NPD
• Sunil Kini, MD

  • Diagnostic Radiology Physician
  • Maywood, IL
  • NPI 1215996681
  NPD

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1730730144",
    "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": "MODESTO MOBILE IMAGING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "DOLE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "209-575-4575"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marks
• Kishauna Makayla Mavis
• Christie Mayer
• Clara Anisel Mendez Baez, DDS
• Robin Lynn Mendez
• Bryanna Moran
• Ryan Murphy, D.P.T.
• Daisy Navarro Gonzalez
• Ella Nielsen, AA, RBT
• Richard Julian Nunes, MD

• Mobile Radiology Clinic/Center in Salida, CA
• Providers in Salida, CA by specialty
• Mobile Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.