Healthcare Provider Details

I. General information

NPI: 1558341073
Provider Name (Legal Business Name): MARIO C GIUDICI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2651 WALNUT AVE
SIGNAL HILL CA
90755-1830
US

IV. Provider business mailing address

2651 WALNUT AVE
SIGNAL HILL CA
90755-1830
US

V. Phone/Fax

Practice location:
  • Phone: 562-912-2507
  • Fax: 562-912-2507
Mailing address:
  • Phone: 562-912-2507
  • Fax: 562-912-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD044468L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number57368
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberE-16797
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA04954900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: