Healthcare Provider Details
I. General information
NPI: 1235554155
Provider Name (Legal Business Name): SOLANO DIAGNOSTICS PARTNERS A CALIF LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2014
Last Update Date: 12/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3007 MOONLIGHT PARK AVE
OXNARD CA
93036-5325
US
IV. Provider business mailing address
4500 BUSINESS CENTER DR
FAIRFIELD CA
94534-6888
US
V. Phone/Fax
- Phone: 213-713-7519
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELNORA
CAMERON
Title or Position: PRESIDENT
Credential:
Phone: 707-646-3288