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General NPI Number Information
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NPI Number | 1063873081
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Entity Type | Organization
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Legal Business Name | MEDX-IMAGING SERVICES
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Dates
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Enumeration Date | 03/18/2016
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Last Update Date | 03/18/2016
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Provider Practice Location Address
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Address Line | 1850 S WATERMAN AVE SUITE F
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-2877
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Country | US
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Telephone | 909-232-0056
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Fax | 951-848-0831
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Provider Business Mailing Address
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Address Line | 16502 WALNUT ST # A SUITE A
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City | HESPERIA
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State | CA
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Zip | 92345-3671
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Country | US
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Telephone | 909-232-0056
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THOMAS CROSBY
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Credential |
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Telephone | 909-232-0056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | RHL 00138666
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License Number State | CA
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