Healthcare Provider Details

I. General information

NPI: 1821236910
Provider Name (Legal Business Name): REGIONAL MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 N CENTRAL AVE
UPLAND CA
91786-4241
US

IV. Provider business mailing address

PO BOX 27128
ANAHEIM CA
92809-0104
US

V. Phone/Fax

Practice location:
  • Phone: 714-238-1155
  • Fax:
Mailing address:
  • Phone: 714-238-1155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Internal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LANDEN MIRALLEGRO
Title or Position: OWNER
Credential:
Phone: 714-238-1155