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General NPI Number Information
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NPI Number | 1124471214
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Entity Type | Organization
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Legal Business Name | RADIOLOGY VISION LLC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 3144 SWEET LILAC WAY
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City | STOCKTON
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State | CA
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Zip | 95209
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Country | US
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Telephone | 619-646-0416
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Fax |
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Provider Business Mailing Address
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Address Line | 6333 PACIFIC AVE # 544
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City | STOCKTON
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State | CA
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Zip | 95207-3713
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Country | US
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Telephone | 619-646-0416
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MR. ASHIM HAYDAR ALI
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Credential |
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Telephone | 619-646-0416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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