PALM IMAGING INSTITUTE A MEDICAL CORPORATION NPI 1063411460

NPI Information

NPI: 1063411460
Provider Name: PALM IMAGING INSTITUTE, A MEDICAL CORPORATION
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
399 E 21ST ST
SAN BERNARDINO, CA
ZIP 92404
Phone: (909) 882-2266
Get Directions

PALM IMAGING INSTITUTE, A MEDICAL CORPORATION is a diagnostic radiology radiology in San Bernardino, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PALM IMAGING INSTITUTE, A MEDICAL CORPORATION NPI is 1063411460. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

399 E 21ST ST
SAN BERNARDINO, CA
ZIP 92404-815
Phone: (909) 882-2266
Fax: (909) 881-7593

The provider's authorized official is Tanie Donaldson .
The authorized official title is Office Manager and has the following contact phone number (909) 882-2266.

The enumeration date for this NPI number is 7/18/2005 and was last updated on 4/23/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207XS0114X	Orthopaedic Surgery	Adult Reconstructive Orthopaedic Surgery	G55682	CALIFORNIA	No
2	207XX0005X	Orthopaedic Surgery	Sports Medicine	A84930	CALIFORNIA	No
3	2085R0202X	Radiology	Diagnostic Radiology	28926	CALIFORNIA	Yes
4	225100000X	Physical Therapist		PT 10673	CALIFORNIA	No
5	363AS0400X	Physician Assistant	Surgical	PA20947	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GR0063970	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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