Healthcare Provider Details
I. General information
NPI: 1457427767
Provider Name (Legal Business Name): TEMPLETON IMAGING MEDICAL CORPORATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/28/2006
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
262 POSADA LANE C
TEMPLETON CA
93465
US
IV. Provider business mailing address
PO BOX 489 262 POSADA LANE C
TEMPLETON CA
93465
US
V. Phone/Fax
- Phone: 805-434-1491
- Fax: 805-434-4997
- Phone: 805-434-1491
- Fax: 805-434-4997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | C2061322 |
| License Number State | CA |
VIII. Authorized Official
Name:
JAMES
POOLE
CARTLAND
Title or Position: PRESIDENT
Credential: MD
Phone: 805-434-1491