Wave Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

WAVE IMAGING LLC

Doing business as

Long Beach PET Imaging Center

Practice address

2710 E Willow St
Signal Hill, CA 90755-2217

Phone

(562) 427-0714

Fax

(562) 427-3652

NPI assigned

Oct 1, 2014

Organization subpart

No

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

Authorized official

Name

Mark D Schafer, MD

Title

Manager

Phone

(657) 241-3500

Specialties & licenses 1

Addresses

Other names 1

• Long Beach PET Imaging Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Memorialcare Medical Foundation

  • Clinic/Center
  • Fountain Valley, CA
  • NPI 1205167350

  Member Of

  NPD member

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423440000000",
    "number": "1932502150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720",
            "telephone_number": "657-241-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 E WILLOW ST",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907552217",
            "telephone_number": "562-427-0714",
            "fax_number": "562-427-3652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVE IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2015-02-09",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "657-241-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Beach PET Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Wallis, P.T., D.P.T.
• Ka'Juan Kepre Warren
• Euna Washington
• Tamara Washington, RN
• Stacy Waung, CPNP-PC
• Eric James Welker, ATC PTA
• Phynix Wilburn
• Lateanara Shonte Williams
• Carolyn Willis
• Paige Willis

• Radiology Clinic/Center in Signal Hill, CA
• Providers in Signal Hill, 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 Feb 9, 2015; 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.