Healthcare Provider Details

I. General information

NPI: 1649202888
Provider Name (Legal Business Name): REGIONAL RADIOLOGICAL ASSOCIATES, INC. A MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 COURT ST
REDDING CA
96001-1822
US

IV. Provider business mailing address

PO BOX 849980
LOS ANGELES CA
90084-9980
US

V. Phone/Fax

Practice location:
  • Phone: 530-243-1236
  • Fax: 530-243-8502
Mailing address:
  • Phone: 530-243-1236
  • Fax: 530-243-8502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SLEPICKA
Title or Position: CFO/CPA
Credential:
Phone: 530-243-1236