Provider Demographics
NPI:1871716035
Name:PALO ALTO MEDICAL IMAGING SERVICES
Entity type:Organization
Organization Name:PALO ALTO MEDICAL IMAGING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-323-1343
Mailing Address - Street 1:400 CHANNING AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2801
Mailing Address - Country:US
Mailing Address - Phone:650-323-1343
Mailing Address - Fax:650-323-1352
Practice Address - Street 1:250 N WESTLAKE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3700
Practice Address - Country:US
Practice Address - Phone:805-370-0200
Practice Address - Fax:805-370-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG617022085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31833ZMedicare ID - Type Unspecified