Provider Demographics
NPI:1295141950
Name:INLAND EMPIRE IMAGING
Entity type:Organization
Organization Name:INLAND EMPIRE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAMESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-237-2240
Mailing Address - Street 1:18111 BROOKHURST ST
Mailing Address - Street 2:SUITE 6100
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6728
Mailing Address - Country:US
Mailing Address - Phone:714-698-0300
Mailing Address - Fax:
Practice Address - Street 1:260 E ONTARIO AVE
Practice Address - Street 2:SUITE 101A
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3506
Practice Address - Country:US
Practice Address - Phone:951-371-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory