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General NPI Number Information
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NPI Number | 1235418856
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Entity Type | Organization
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Legal Business Name | ULTRASONIC RADIOLOGY
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Dates
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Enumeration Date | 08/12/2011
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 1842 W LINCOLN AVE STE A
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City | ANAHEIM
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State | CA
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Zip | 92801-5489
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Country | US
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Telephone | 714-595-9012
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Fax |
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Provider Business Mailing Address
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Address Line | 800 S BROOKHURST ST STE 3A
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City | ANAHEIM
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State | CA
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Zip | 92804-4301
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Country | US
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Telephone | 714-595-9012
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | AMGAD SALEM
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Credential | ARDMS,RDCS,RVT
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Telephone | 714-595-9012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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