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General NPI Number Information
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NPI Number | 1407232127
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL DIAGNOSTICS
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 11843 SEBASTIAN WAY STE 101
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0710
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Country | US
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Telephone | 909-654-6731
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Fax | 866-663-2407
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Provider Business Mailing Address
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Address Line | 11843 SEBASTIAN WAY STE 101
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0710
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Country | US
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Telephone | 909-654-6731
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Fax | 866-663-2407
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SINA RAFISOLYMAN
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Credential | MD
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Telephone | 310-993-6830
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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 | A85825
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License Number State | CA
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