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General NPI Number Information
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NPI Number | 1013012921
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Entity Type | Organization
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Legal Business Name | ARROWHEAD RADIOLOGY MEDICAL GROUP INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | 600 N HIGHLAND SPRINGS AVE
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City | BANNING
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State | CA
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Zip | 92220-3046
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Country | US
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Telephone | 951-845-1121
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Fax | 951-845-8904
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Provider Business Mailing Address
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Address Line | 400 N PEPPER AVE
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City | COLTON
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State | CA
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Zip | 92324-1801
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Country | US
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Telephone | 909-580-1520
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Fax | 909-580-1561
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Authorized Official
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Title or Position | PRESIDENT
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Name | FREDRICK L ORR
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Credential | M.D.
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Telephone | 909-845-1121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | CA
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