Provider Demographics
NPI:1053610360
Name:ASSURED IMAGING WOMEN'S WELLNESS OF CALIFORNIA, INC.
Entity type:Organization
Organization Name:ASSURED IMAGING WOMEN'S WELLNESS OF CALIFORNIA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-774-8828
Mailing Address - Street 1:7717 N HARTMAN LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-9506
Mailing Address - Country:US
Mailing Address - Phone:888-233-6121
Mailing Address - Fax:520-572-7138
Practice Address - Street 1:110 N VALLEY OAKS DR STE C
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-6790
Practice Address - Country:US
Practice Address - Phone:888-233-6121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSURED IMAGING WOMENS WELLNESS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-25
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography