Organization Active NPI

Mrimaging of California, a Medical Corporation

  • Diagnostic Radiology Physician
  • San Jose, CA
National Provider Identifier
1760475321
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MRIMAGING OF CALIFORNIA, A MEDICAL CORPORATION
Practice address
2105 Forest Ave
Ste M
San Jose, CA 95128-1425
Phone
(888) 440-6494
Fax
(330) 759-1501
NPI assigned
Aug 29, 2005
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
David L Bloom, MD
Title
President
Phone
(973) 707-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X CA Primary

Addresses

Primary practice location

2105 Forest Ave
Ste M
San Jose, CA 95128-1425

Mailing address

1455 Broad St
4TH Floor
Bloomfield, NJ 07003-3003
Phone (973) 707-1100

Other identifiers 1

IdentifierTypeStateIssuer
GR0030330MedicaidCA

Other names 1

  • MRImaging of California, a Medical Corporation Doing business as

National Provider Directory

National Provider Directory

Locations

2105 Forest Ave
Ste M
San Jose, CA 95128
Phone (408) 947-2900

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1760475321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 BROAD ST",
            "address_2": "4TH FLOOR",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033003",
            "telephone_number": "973-707-1100",
            "fax_number": "973-707-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "address_2": "STE M",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "888-440-6494",
            "fax_number": "330-759-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRIMAGING OF CALIFORNIA, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-707-1100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0030330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRImaging of California, a Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, 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.