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Organization
MODERN DIAGNOSTIC IMAGING PC
Active
Organization
MODERN DIAGNOSTIC IMAGING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEETAL G. MEHTA (OWNER)
(480) 445-9961
Entity
Organization
Contact information
Practice address
600 S DOBSON RD, B16, CHANDLER, AZ 85224-5678
(480) 445-9961
(480) 445-9972
Mailing address
600 S DOBSON RD, B16, CHANDLER, AZ 85224-5678
(480) 445-9961
(480) 445-9972
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181760
—
AZ
01
—
2Z2341
HEALTH NET OF ARIZONA
AZ
01
—
AZ0153760
BCBSAZ
AZ
Enumeration date
02/17/2006
Last updated
03/12/2012
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