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General NPI Number Information
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NPI Number | 1316362239
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Entity Type | Organization
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Legal Business Name | SOLANO DIAGNOSTICS IMAGING MEDICAL GROUP
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Dates
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Enumeration Date | 02/28/2014
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 317 N PALM DR # 4C
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4184
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Country | US
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Telephone | 818-606-3951
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 BUSINESS CENTER DR
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City | FAIRFIELD
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State | CA
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Zip | 94534-6888
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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 | PRESIDENT
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Name | ELNORA CAMERON
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Credential |
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Telephone | 707-646-3288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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