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General NPI Number Information
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NPI Number | 1093552689
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Entity Type | Organization
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Legal Business Name | SADDLEBACK PORTABLE X-RAY LLC
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Dates
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Enumeration Date | 07/10/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 1651 E 4TH ST STE 212
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City | SANTA ANA
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State | CA
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Zip | 92701-5142
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Country | US
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Telephone | 714-835-2915
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Fax | 714-543-3114
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Provider Business Mailing Address
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Address Line | 1651 E 4TH ST STE 212
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City | SANTA ANA
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State | CA
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Zip | 92701-5142
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Country | US
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Telephone | 714-835-2915
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Fax | 714-543-3114
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Authorized Official
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Title or Position | OWNER
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Name | MR. TONY CASTILLO
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Credential | CRT
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Telephone | 949-289-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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