Healthcare Provider Details

I. General information

NPI: 1952611394
Provider Name (Legal Business Name): NUCLEAR MEDICINE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 10/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2438 N PONDEROSA DR BUILDING C, SUITE #201
CAMARILLO CA
93010-2369
US

IV. Provider business mailing address

2438 N PONDEROSA DR BUILDING C, SUITE #201
CAMARILLO CA
93010-2369
US

V. Phone/Fax

Practice location:
  • Phone: 805-484-4612
  • Fax: 805-965-6712
Mailing address:
  • Phone: 805-484-4612
  • Fax: 805-965-6712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM M. PACE
Title or Position: CEO
Credential: M.D.
Phone: 805-637-1313