Provider Demographics
NPI:1053032045
Name:ACCENT 3T MRI INC
Entity type:Organization
Organization Name:ACCENT 3T MRI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-417-2766
Mailing Address - Street 1:3800 WILSHIRE BLVD STE 110DE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-3231
Mailing Address - Country:US
Mailing Address - Phone:213-302-7500
Mailing Address - Fax:213-302-7510
Practice Address - Street 1:3800 WILSHIRE BLVD STE 110DE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3231
Practice Address - Country:US
Practice Address - Phone:213-302-7500
Practice Address - Fax:213-302-7510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology