Healthcare Provider Details

I. General information

NPI: 1437572641
Provider Name (Legal Business Name): T&T ULTRASOUND IMAGING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15022 NEECE ST
WESTMINSTER CA
92683-5451
US

IV. Provider business mailing address

15022 NEECE ST
WESTMINSTER CA
92683-5451
US

V. Phone/Fax

Practice location:
  • Phone: 714-797-8040
  • Fax: 714-839-9175
Mailing address:
  • Phone: 714-797-8040
  • Fax: 714-839-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number121896
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number121896
License Number StateMD

VIII. Authorized Official

Name: LOC NGUYEN
Title or Position: PRINCIPAL
Credential: RDMS, RVT
Phone: 714-797-8050