MOTHER LODE DIAGNOSTIC IMAGING INC NPI 1053456061

NPI Information

  • NPI: 1053456061
  • Provider Name: MOTHER LODE DIAGNOSTIC IMAGING INC
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Organization
  • Address: 200 MISSION BLVD
    JACKSON, CA
    ZIP 95642
  • Phone: (209) 223-0949

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NPI Details

MOTHER LODE DIAGNOSTIC IMAGING INC is a diagnostic radiology radiology in Jackson, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MOTHER LODE DIAGNOSTIC IMAGING INC NPI is 1053456061. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 MISSION BLVD
JACKSON, CA
ZIP 95642-564
Phone: (209) 223-0949
Fax: (209) 223-0965

The provider's authorized official is Batxer Richardson .
The authorized official title is President and has the following contact phone number (209) 223-7560.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 10/7/2022.

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
12085R0202XRadiologyDiagnostic RadiologyYes

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
1GR0043480MEDICAIDCALIFORNIA

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: 11/21/2025

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