Elite Diagnostic Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

ELITE DIAGNOSTIC IMAGING, LLC

Practice address

17260 Bear Valley Rd
Suite 109
Victorville, CA 92395-7777

Phone

(760) 843-2900

Fax

(760) 843-0144

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Hector A. Torres

Title

Coo

Phone

(760) 843-2900

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1821178856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17260 BEAR VALLEY RD",
            "address_2": "SIUTE 112",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957777",
            "telephone_number": "760-843-2900",
            "fax_number": "760-843-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17260 BEAR VALLEY RD",
            "address_2": "SUITE 109",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957777",
            "telephone_number": "760-843-2900",
            "fax_number": "760-843-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTIC IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "760-843-2900"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "200432110020",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.