Healthcare Provider Details

I. General information

NPI: 1790032753
Provider Name (Legal Business Name): VALLEY RADIOLOGY CONSULTANTS MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 AUSTIN DR STE 105
SPRING VALLEY CA
91978-1521
US

IV. Provider business mailing address

1340 W VALLEY PKWY STE 202
ESCONDIDO CA
92029-2136
US

V. Phone/Fax

Practice location:
  • Phone: 619-797-8248
  • Fax: 619-399-7359
Mailing address:
  • Phone: 760-520-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT STEVEN MUEHLBERG
Title or Position: CEO
Credential:
Phone: 760-520-8551