DIGNITY HEALTH MEDICAL FOUNDATION NPI 1821028200

NPI Information

NPI: 1821028200
Provider Name: DIGNITY HEALTH MEDICAL FOUNDATION

Doing Business As: MERCY IMAGING CENTERS, A SERVICE OF DIGNITY HEALTH MEDICAL FOUNDATION

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

CLIA Number: 05D2019021

Address:
2110 PROFESSIONAL DR
SUITE 190
ROSEVILLE, CA
ZIP 95661
Phone: (916) 787-0404
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DIGNITY HEALTH MEDICAL FOUNDATION is a radiology clinic center in Roseville, CA. DIGNITY HEALTH MEDICAL FOUNDATION NPI is 1821028200. The provider is registered as an organization entity type.
The provider Is Doing Business As Mercy Imaging Centers, A Service Of Dignity Health Medical Foundation.

The provider's business location address is:

2110 PROFESSIONAL DR
SUITE 190
ROSEVILLE, CA
ZIP 95661-752
Phone: (916) 787-0404
Fax: (916) 787-0434

The provider's authorized official is Theresa M Hylen .
The authorized official title is Chief Financial Officer and has the following contact phone number (916) 851-2559.

The CLIA number assigned to this NPI record is 05D2019021 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 11/18/2020.

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	261QR0200X	Clinic/Center	Radiology			Yes

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	ZZZ25297Z	OTHER	CALIFORNIA	BLUE SHIELD
2	GR001137J	OTHER	CALIFORNIA	MEDI-CAL

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

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