Organization
ADVANCED IMAGING OF LAFAYETTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINAL AMIN (VP FINANCE)
(800) 544-3215
Entity
Organization
Contact information
Practice address
935 CAMELLIA BLVD, SUITE 101, LAFAYETTE, LA 70508-7084
(333) 984-2036
(337) 984-7604
Mailing address
18201 VON KARMAN AVE STE 600, IRVINE, CA 92612-1176
(800) 544-3215
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1601489
UNITED OF LA
LA
01
—
2193687
FIRST HEALTH/CCN
LA
01
—
7266595
AETNA
LA
Enumeration date
03/15/2006
Last updated
12/30/2019
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