Healthcare Provider Details

I. General information

NPI: 1164631081
Provider Name (Legal Business Name): FAMILY RADIOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 LOMITA BLVD STE 151
TORRANCE CA
90505-4865
US

IV. Provider business mailing address

3440 LOMITA BLVD STE 151
TORRANCE CA
90505-4865
US

V. Phone/Fax

Practice location:
  • Phone: 310-530-2624
  • Fax:
Mailing address:
  • Phone: 310-530-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GEOVANNI LOPEZ
Title or Position: DIRECTOR
Credential:
Phone: 310-530-2624