Healthcare Provider Details

I. General information

NPI: 1336642685
Provider Name (Legal Business Name): RADEX MOBILE NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 E 4TH ST STE 236
SANTA ANA CA
92701-5144
US

IV. Provider business mailing address

1633 E 4TH ST STE 236
SANTA ANA CA
92701-5144
US

V. Phone/Fax

Practice location:
  • Phone: 714-474-1149
  • Fax: 866-888-0865
Mailing address:
  • Phone: 714-474-1149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. CONRADO OLALIA QUEMUEL
Title or Position: CEO
Credential: CRT
Phone: 714-474-1149