Organization
SIMPLY MOBILE X-RAY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN Y CHANG R.T. (PRESIDENT)
(928) 261-6379
Entity
Organization
Contact information
Practice address
3661 W 12TH LN, YUMA, AZ 85364-9107
(928) 261-6379
(928) 276-4834
Mailing address
3661 W 12TH LN, YUMA, AZ 85364-9107
(928) 261-6379
(928) 276-4834
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
CRT-14994
AZ
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
RHT 92930
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
443363
—
AZ
01
—
P00733483
MEDICARE RAILROAD CARRIER
AZ
Enumeration date
09/15/2008
Last updated
05/03/2013
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