Back Bay Imaging Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

BACK BAY IMAGING INC.

Practice address

301 Bayview Cir
Suite 105
Newport Beach, CA 92660-2948

Phone

(310) 736-4395

NPI assigned

Jan 23, 2017

Last updated

Jan 30, 2017By 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

Robert Petzold

Title

Manager

Phone

(310) 736-4395

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1891232294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 102",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-736-4395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BAYVIEW CIR",
            "address_2": "SUITE 105",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602948",
            "telephone_number": "310-736-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK BAY IMAGING INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "PETZOLD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "310-736-4395"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivek Babaria, D.O.
• Maxine Kay Babazadeh, M.P.T
• Ganna Babenko
• Katia Babitzke
• Nicholas M. Bacher, MD
• Back Bay Medical LLC (Advanced Body Scan of Newport)
• Back Bay Surgery Center
• Pejman Badiei, M.D.
• Jennifer Eileen Badillo
• Annie Jin Bae

• Radiology Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, 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 Jan 30, 2017; 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.