Healthcare Provider Details

I. General information

NPI: 1083932925
Provider Name (Legal Business Name): ECHO ON-SITE MOBILE IMAGING, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2010
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11510 PRIVET PL
BAKERSFIELD CA
93311-9332
US

IV. Provider business mailing address

11510 PRIVET PL
BAKERSFIELD CA
93311-9332
US

V. Phone/Fax

Practice location:
  • Phone: 661-310-0722
  • Fax: 661-200-5511
Mailing address:
  • Phone: 661-310-0722
  • Fax: 661-200-5511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA90677
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberA90677
License Number StateCA

VIII. Authorized Official

Name: DR. YALCIN HACIOGLU
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: M.D.
Phone: 661-310-0722