Healthcare Provider Details

I. General information

NPI: 1972812436
Provider Name (Legal Business Name): REGIONAL DIAGNOSTIC IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 10/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 IOWA AVE SUITE 280
RIVERSIDE CA
92507-2430
US

IV. Provider business mailing address

PO BOX 26750
FRESNO CA
93729-6750
US

V. Phone/Fax

Practice location:
  • Phone: 951-786-0801
  • Fax: 951-786-0460
Mailing address:
  • Phone: 559-455-4000
  • Fax: 770-666-9102

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: DR. HARMANDEEP KAUR GILL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 661-948-4781