| NPI | 1972607091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDMUND WYCOFF Administrator 626-577-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085R0204X Radiology Vascular & Interventional Radiology |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2008-08-28 |