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General NPI Number Information
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NPI Number | 1376719914
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Entity Type | Organization
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Legal Business Name | RADNET
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Dates
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Enumeration Date | 05/04/2008
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 35800 BOB HOPE DR SUITE 150A
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1739
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Country | US
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Telephone | 760-770-1920
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Fax |
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Provider Business Mailing Address
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Address Line | 73373 COUNTRY CLUB DR 2113
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City | PALM DESERT
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State | CA
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Zip | 92260-8624
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Country | US
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Telephone | 805-236-6623
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NASTARAN FATEMI
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Credential | MD
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Telephone | 310-966-8509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 39
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A111261
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License Number State | CA
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