NPIMap

Organization Active NPI

Mantro Mobile Imaging LLC

Doing business as Mantro Mobile Imaging of California

  • Mobile Radiology Clinic/Center
  • Whittier, CA
National Provider Identifier
1811272669
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
Legal business name
MANTRO MOBILE IMAGING LLC
Doing business as
Mantro Mobile Imaging of California
Practice address
6528 Greenleaf Ave Suite 209
Whittier, CA 90601-4131
Phone
(888) 592-0550
Fax
(888) 600-1534
NPI assigned
Oct 12, 2011
Organization subpart
Yes
Parent organization
MANTRO MOBILE IMAGING LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Authorized official

Name
Mr. John A Missig, RN,BSN
Title
Ceo/Coo
Phone
(434) 989-8851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X Primary

Addresses

Primary practice location

6528 Greenleaf Ave Suite 209
Whittier, CA 90601-4131

Mailing address

8778 S Maryland Pkwy Ste 105
Las Vegas, NV 89123-6705
Phone (888) 592-0550

Other identifiers 1

IdentifierTypeStateIssuer
GH589AOtherCAPTAN

Other names 1

  • Mantro Mobile Imaging of California Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111102000312 CA Part B Supplier - Portable X-Ray Supplier 3476657669 Practice locations: Whittier, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mantro Mobile Imaging LLC5 organizations share this tax ID, including this one
Part of
Mantro Mobile Imaging LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1811272669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8778 S MARYLAND PKWY STE 105",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891236705",
            "telephone_number": "888-592-0550",
            "fax_number": "888-600-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6528 GREENLEAF AVE SUITE 209",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014131",
            "telephone_number": "888-592-0550",
            "fax_number": "888-600-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTRO MOBILE IMAGING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANTRO MOBILE IMAGING LLC",
        "enumeration_date": "2011-10-12",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "MISSIG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/COO",
        "authorized_official_telephone_number": "434-989-8851",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN,BSN"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "GH589A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mantro Mobile Imaging of California",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mantro Mobile Imaging of California",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.