Healthcare Provider Details

I. General information

NPI: 1972437135
Provider Name (Legal Business Name): SEAN DEICHMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 NE NEFF RD
BEND OR
97701-6015
US

IV. Provider business mailing address

23919 CARLAND DR
NEWHALL CA
91321-3431
US

V. Phone/Fax

Practice location:
  • Phone: 661-713-6848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number3429
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: