Organization Active NPI

Millennium Diagnostic Imaging Service Inc

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Anaheim, CA
National Provider Identifier
1992017057
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
MILLENNIUM DIAGNOSTIC IMAGING SERVICE INC
Practice address
1305 S. Courson Drive
Anaheim, CA 92804-4721
Phone
(877) 277-7848
Fax
(855) 464-4936
NPI assigned
Jul 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Authorized official

Name
Mr. Sukhpal Singh KhunkhunNPI 1093894909
Title
Ceo
Phone
(877) 277-7848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

1305 S. Courson Drive
Anaheim, CA 92804-4721

Mailing address

1305 S Courson Dr
Anaheim, CA 92804-4721
Phone (877) 277-7848

Other practice location 1

32310 Aquaduct Rd
Bonsall, CA 92003-4303
Phone (877) 277-7848

Other names 1

  • MDIS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110309000326 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4284816463 Practice locations: Anaheim, CA
O20220203000475 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 5597158105 Practice locations: Anaheim, CA

National Provider Directory

National Provider Directory
Tax ID family
Mdis2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2200 Harbor Blvd
Ste B210
Costa Mesa, CA 92627
Phone (949) 548-2273

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1992017057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S COURSON DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044721",
            "telephone_number": "877-277-7848",
            "fax_number": "855-464-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S. COURSON DRIVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044721",
            "telephone_number": "877-277-7848",
            "fax_number": "855-464-4936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32310 Aquaduct Rd",
            "address_purpose": "LOCATION",
            "city": "Bonsall",
            "state": "CA",
            "postal_code": "920034303",
            "country_code": "US",
            "telephone_number": "877-277-7848",
            "fax_number": "855-464-4936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MILLENNIUM DIAGNOSTIC IMAGING SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-06",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "KHUNKHUN",
        "authorized_official_first_name": "SUKHPAL",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-277-7848",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MDIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; 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.