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General NPI Number Information
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NPI Number | 1013295963
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Entity Type | Organization
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Legal Business Name | CREATIVE ULTRASOUND IMAGING INC.
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 12/01/2015
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Provider Practice Location Address
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Address Line | 47 SAN MIGUEL AVE STE. 4
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City | SALINAS
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State | CA
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Zip | 93901-3058
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Country | US
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Telephone | 831-272-3576
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Fax | 831-272-3576
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Provider Business Mailing Address
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Address Line | 47 SAN MIGUEL AVE STE. 4
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City | SALINAS
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State | CA
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Zip | 93901-3058
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Country | US
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Telephone | 831-272-3576
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Fax | 831-272-3576
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Authorized Official
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Title or Position | OWNER
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Name | PHILOMINA DUESDIEKER
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Credential | RVT
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Telephone | 831-272-3576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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