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General NPI Number Information
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NPI Number | 1235261017
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Entity Type | Organization
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Legal Business Name | J. T. IMAGING
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 281 N ALTADENA DR # F
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City | PASADENA
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State | CA
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Zip | 91107-3364
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Country | US
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Telephone | 626-483-2632
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Fax | 909-444-0108
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Provider Business Mailing Address
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Address Line | PO BOX 1183
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City | TEMPLE CITY
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State | CA
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Zip | 91780-1183
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Country | US
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Telephone | 626-483-2632
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Fax | 909-444-0108
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Authorized Official
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Title or Position | OWNER
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Name | MAGED TAWADROS
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Credential |
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Telephone | 626-483-2632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | X0010016
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License Number State | CA
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