=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003248188
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KLEAR VIEW IMAGING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2013
-----------------------------------------------------
Last Update Date | 07/31/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1062 SARATOGA AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95129-3402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-982-9915
-----------------------------------------------------
Fax | 408-380-4079
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1062 SARATOGA AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95129-3402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-564-0071
-----------------------------------------------------
Fax | 408-380-4079
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PHILL TONG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 408-564-0071
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2471S1302X
-----------------------------------------------------
Taxonomy Name | Sonography Radiologic Technologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------