Healthcare Provider Details

I. General information

NPI: 1699131730
Provider Name (Legal Business Name): QUANTUM MEDICAL RADIOLOGY OF CALIFORNIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2016
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 E CLINTON WAY
FRESNO CA
93727-2040
US

IV. Provider business mailing address

5638 NORTHINGTON CT
WEST BLOOMFIELD MI
48322-1350
US

V. Phone/Fax

Practice location:
  • Phone: 559-455-4065
  • Fax:
Mailing address:
  • Phone: 404-870-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCIS FERRARO
Title or Position: CFO
Credential:
Phone: 404-870-2802