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General NPI Number Information
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NPI Number | 1235498437
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Entity Type | Organization
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Legal Business Name | PREFERRED DIAGNOSTIC IMAGING LLC.
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 10230 ARTESIA BLVD STE 100
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City | BELLFLOWER
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State | CA
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Zip | 90706-6763
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Country | US
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Telephone | 562-461-2585
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Fax | 562-461-2591
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Provider Business Mailing Address
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Address Line | 10230 ARTESIA BLVD STE 100
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City | BELLFLOWER
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State | CA
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Zip | 90706-6763
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Country | US
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Telephone | 562-461-2585
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Fax | 562-461-2591
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Authorized Official
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Title or Position | RADIOLOGY MANAGER
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Name | RICK RENE RIVERA
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Credential |
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Telephone | 562-461-2585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | FAC00068339
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License Number State | CA
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