Provider Demographics
NPI:1174747877
Name:ECHO TECHIMAGING INC
Entity type:Organization
Organization Name:ECHO TECHIMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICKI
Authorized Official - Middle Name:L
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS,RDCS,RVT
Authorized Official - Phone:805-522-5711
Mailing Address - Street 1:2650 JONES WAY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1203
Mailing Address - Country:US
Mailing Address - Phone:805-522-5711
Mailing Address - Fax:805-522-0844
Practice Address - Street 1:2650 JONES WAY
Practice Address - Street 2:SUITE 9
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1203
Practice Address - Country:US
Practice Address - Phone:805-522-5711
Practice Address - Fax:805-522-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2471C1106X, 2471S1302X, 2471V0105X
CA2471C1106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C1106XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistCardiac-Interventional TechnologyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG530Medicare PIN