Basic Information
| Provider Information | |||||||||
| NPI: | 1093959389 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE HEALTHCARE SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 BAYVIEW CIR | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926602983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9492425384 | ||||||||
| FaxNumber: | 4802128589 | ||||||||
| Practice Location | |||||||||
| Address1: | 1402 E COUNTY LINE RD | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462270963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666677226 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2009 | ||||||||
| LastUpdateDate: | 07/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | POAN | ||||||||
| AuthorizedOfficialFirstName: | NICHOLAS | ||||||||
| AuthorizedOfficialMiddleName: | A. | ||||||||
| AuthorizedOfficialTitleorPosition: | SVP, CORPORATE FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9492425321 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0208X | IN | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile |
No ID Information.