Healthcare Provider Details

I. General information

NPI: 1861731796
Provider Name (Legal Business Name): NOVO IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5170 GOLDEN FOOTHILL PKWY
EL DORADO HILLS CA
95762-9608
US

IV. Provider business mailing address

PO BOX 4993
EL DORADO HILLS CA
95762-0027
US

V. Phone/Fax

Practice location:
  • Phone: 916-850-2726
  • Fax:
Mailing address:
  • Phone: 916-850-2726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELE LAING
Title or Position: COO
Credential:
Phone: 916-850-2726