Organization
ALLIANCE HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LONGMORE-GRUND (EXEC VP& CFO)
(800) 544-3215
Entity
Organization
Contact information
Practice address
11500 BROOKSHIRE AVE, DOWNEY, CA 90241-4917
(562) 904-5000
Mailing address
100 BAYVIEW CIRCLE, SUITE 400, NEWPORT BEACH, CA 92660-2984
(800) 544-3215
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
6640-30
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IDTF00490
—
CA
01
—
ZZZ09935Z
BLUES SHIELD OF CA
CA
01
—
ZZZ64004Z
BLUE SHIELD OF CA
CA
Enumeration date
11/29/2006
Last updated
09/20/2016
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