# PACIFIC COAST MOBILE RADIOLOGY, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659037125
- **Authorized official:** ERIK CHAVEZ (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (714) 758-0660

## Contact information

- **Practice address:** 1440 S STATE COLLEGE BLVD STE 3K, ANAHEIM, CA 92806-5721
- **Practice address phone:** (714) 758-0660
- **Mailing address:** 1440 S STATE COLLEGE BLVD STE 3K, ANAHEIM, CA 92806-5721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0207X | Mobile Mammography Clinic/Center | — | NULL | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 11/09/2021
- **Last updated:** 02/06/2024