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General NPI Number Information
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NPI Number | 1386971646
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Entity Type | Organization
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Legal Business Name | MONTCLAIR ULTRASOUND HEALTH CENTER, INC.
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Dates
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Enumeration Date | 11/06/2009
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Last Update Date | 01/06/2010
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Provider Practice Location Address
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Address Line | 5206 BENITO ST SUITE 105
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City | MONTCLAIR
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State | CA
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Zip | 91763-2852
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Country | US
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Telephone | 909-509-5919
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Fax | 909-992-3182
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Provider Business Mailing Address
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Address Line | 5206 BENITO ST SUITE 105
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City | MONTCLAIR
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State | CA
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Zip | 91763-2852
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Country | US
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Telephone | 909-509-5919
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Fax | 909-992-3182
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Authorized Official
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Title or Position | DIRECTOR
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Name | DONALD JOSE CABRERA SR.
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Credential |
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Telephone | 800-838-0384
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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 | A70349
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License Number State | CA
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