Organization
EAST VALLEY DIAGNOSTIC IMAGING LLC
Active
Other names
EVDI Medical Imaging, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN W. MARKS (ADMINISTRATOR)
(480) 272-8004
Entity
Organization
Contact information
Practice address
1125 E. SOUTHERN AVE, STE 200, MESA, AZ 85204-5046
(480) 545-8119
(480) 926-8332
Mailing address
1125 E. SOUTHERN AVE, STE 200, MESA, AZ 85204-5046
(480) 545-8119
(480) 926-8332
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
585681
—
AZ
Enumeration date
08/12/2006
Last updated
07/20/2010
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