| NPI | 1740360551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RAYMOND CEO 760-547-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: CA BL50458687) |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging (Licence: CA BL50458687) |
| 2085N0904X (Licence: CA BL50458687) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA BL50458687) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: CA BL50458687) | |
| 363A00000X Physician Assistant (Licence: CA BL50458687) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-02-14 |