| NPI | 1649575671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER PRESTON MAYNARD President/Radiologist 310-671-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA C33935) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA C33935) |
| 2085N0700X (Licence: CA C33935) | |
| 2085N0904X (Licence: CA C33935) | |
| 2085P0229X Radiology, Pediatric Radiology (Licence: CA C33935) | |
| 2085R0203X Radiology, Therapeutic Radiology (Licence: CA C33935) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA C33935) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA C33935) | |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2023-03-07 |