Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Grand Canyon Medical Imaging LLC

Organization Specialist · NPI 1629109095

Grand Canyon Medical Imaging LLC provides Specialist services in Kingman, Arizona. Licensed in Arizona. Registered with an NPI since 2007.

Licensed in
AZ
In the registry since
2007
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3269 Stockton Hill Rd
Kingman, AZ 86401-3619 Not confirmed with CMS for 19 years — call before visiting
Phone: (928) 757-0620
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X (AZ)

Record details

NPI number1629109095
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Burge — Managing Partner · (714) 754-5800
NPI enumeratedMarch 8, 2007
Last updated in NPPESJuly 12, 2007
Mailing addressPo Box 73878, San Clemente, CA 92673-0130

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