Healthcare Provider Details

I. General information

NPI: 1326359449
Provider Name (Legal Business Name): TORRANCE RADIOLOGY MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 SKYPARK DR SUITE A
TORRANCE CA
90505-5027
US

IV. Provider business mailing address

3275 SKYPARK DR SUITE A
TORRANCE CA
90505-5027
US

V. Phone/Fax

Practice location:
  • Phone: 310-318-5333
  • Fax: 310-318-5353
Mailing address:
  • Phone: 310-318-5333
  • Fax: 310-318-5353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG20626
License Number StateCA

VIII. Authorized Official

Name: DR. MITCHELL PARVER
Title or Position: PARTNER
Credential: MD
Phone: 310-318-5333