Organization
ARIZONA DIAGNOSTIC IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON NELSON (ADMINISTRATOR)
(480) 655-7517
Entity
Organization
Contact information
Practice address
456 N MESA DR, MESA, AZ 85201-5913
(480) 655-7517
(480) 668-7546
Mailing address
456 N MESA DR, MESA, AZ 85201-5913
(480) 655-7517
(480) 668-7546
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0206340
BLUE CROSS
AZ
01
—
1Z0924
HEALTH NET ID
AZ
05
—
481820
—
AZ
Enumeration date
04/14/2006
Last updated
08/22/2020
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