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General NPI Number Information
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NPI Number | 1275252835
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Entity Type | Organization
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Legal Business Name | GREEN LIFE ULTRASOUND USA
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 2375 PRESADO DR UNIT B
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City | DIAMOND BAR
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State | CA
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Zip | 91765-5100
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Country | US
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Telephone | 626-362-1275
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Fax |
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Provider Business Mailing Address
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Address Line | 2375 PRESADO DR UNIT B
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City | DIAMOND BAR
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State | CA
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Zip | 91765-5100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | XIAO LIU
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Credential |
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Telephone | 626-362-1275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State |
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