# SOUTHERN CALIFORNIA PORTABLE X-RAY &EKG

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

## Provider details

- **NPI number:** 1902003429
- **Authorized official:** MR. MICHAEL M ASALY (PRESIDENT)
- **Authorized official phone:** (714) 979-2581

## Contact information

- **Practice address:** 125 BAKER ST E, STE.\#110, COSTA MESA, CA 92626-4509
- **Practice address phone:** (714) 979-2581
- **Practice address fax:** (714) 979-2584
- **Mailing address:** 125 BAKER ST E, STE.\#110, COSTA MESA, CA 92626-4509
- **Mailing address phone:** (714) 979-2581
- **Mailing address fax:** (714) 979-2584

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | RHT41451 | CA | Yes |

## Other

- **Enumeration date:** 06/28/2007
- **Last updated:** 08/22/2020