Organization
MORENO VALLEY IMAGING, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN HENNEBRY (CFO)
(951) 242-2508
Entity
Organization
Contact information
Practice address
12818 HEACOCK ST, SUITE C2, MORENO VALLEY, CA 92553-3173
(951) 242-2508
(951) 242-2548
Mailing address
12818 HEACOCK ST, SUITE C2, MORENO VALLEY, CA 92553-3173
(951) 242-2508
(951) 242-2548
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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