Organization
MIRACOR DIAGNOSTICS, INC.
Active
Other names
Wide Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
GAELANE ROSINSKI (CONTRACTING/CREDENTIALING SPECIALIS)
(847) 658-0996
Entity
Organization
Contact information
Practice address
3715 E SOUTH ST, LONG BEACH, CA 90805-4521
(562) 602-0700
(562) 602-0727
Mailing address
3715 E SOUTH ST, LONG BEACH, CA 90805-4521
(562) 602-0700
(562) 602-0727
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
CA
Other
Enumeration date
08/23/2006
Last updated
08/22/2020
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