| NPI | 1700868338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELONIE STORER Credentialing Administrator 951-302-2223 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A34125) |
| Additional Taxonomies | 2085D0003X Radiology, Diagnostic Neuroimaging |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2010-01-13 |