Look up the most recent NPI and PECOS records

Vital Imaging Medical Group Inc.

Specialist

Other Service Providers

2500 E Ball Rd Ste 200, Anaheim, CA 92806-5063

PECOS Enrollment

Based on the most recent information from CMS, provider Vital Imaging Medical Group Inc. does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:36 AM.

Profile Details

Provider ID
1881034700
Provider Type
Organization
Full Name
Vital Imaging Medical Group Inc.

Subpart
No
Enumeration Date
6/25/2013
Last Updated
6/25/2013

Contact Information

Practice Location

2500 E Ball Rd Ste 200, Anaheim, CA 92806-5063

(714) 284-0111

Unlisted Fax

Mailing Location

2500 E Ball Rd Ste 200, Anaheim, CA 92806-5063

(714) 284-0111

Unlisted Fax

Authorized Official

Ahmed, Ghazala (Secretary)

(714) 284-0111

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License FNP40391 California

Vital Imaging Medical Group Inc.

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

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Description

License

Code

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License

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