Healthcare Provider Details

I. General information

NPI: 1699707174
Provider Name (Legal Business Name): OASIS RADIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47-111 MONROE ST
INDIO CA
92201-6739
US

IV. Provider business mailing address

DEPT LA 21607
PASADENA CA
91185-1607
US

V. Phone/Fax

Practice location:
  • Phone: 760-775-8066
  • Fax: 760-775-8181
Mailing address:
  • Phone: 949-263-8620
  • Fax: 949-263-1639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON CORD
Title or Position: PARTNER
Credential: MD
Phone: 760-775-8066