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General NPI Number Information
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NPI Number | 1396288908
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN IMAGING
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 1107 W POPLAR AVE
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City | PORTERVILLE
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State | CA
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Zip | 93257-5839
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Country | US
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Telephone | 559-759-4752
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7449
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City | VISALIA
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State | CA
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Zip | 93290-7449
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Country | US
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Telephone | 559-759-4752
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. FRANK A MACALUSO JR.
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Credential | M.D.
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Telephone | 559-284-1447
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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 |
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License Number State | CA
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