Organization
ANAHEIM HILLS MEDICAL IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BROCKETT (CEO)
(949) 250-4500
Entity
Organization
Contact information
Practice address
500 S ANAHEIM HILLS RD, #136, ANAHEIM HILLS, CA 92807-4780
(714) 282-8160
(714) 282-7031
Mailing address
500 S ANAHEIM HILLS RD, #136, ANAHEIM HILLS, CA 92807-4780
(714) 282-8160
(714) 282-7031
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ09900Z
BLUE SHIELD
CA
Enumeration date
04/05/2006
Last updated
08/22/2020
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