Provider Demographics
NPI:1447441738
Name:COMPUTERIZED DIAGNOSTIC IMAGING CENTER
Entity type:Organization
Organization Name:COMPUTERIZED DIAGNOSTIC IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:MASSEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-781-2270
Mailing Address - Street 1:4000 14TH ST
Mailing Address - Street 2:SUITE #109
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-4083
Mailing Address - Country:US
Mailing Address - Phone:951-781-2270
Mailing Address - Fax:
Practice Address - Street 1:4000 14TH ST
Practice Address - Street 2:SUITE #109
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4083
Practice Address - Country:US
Practice Address - Phone:951-781-2270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty