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General NPI Number Information
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NPI Number | 1407963275
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Entity Type | Organization
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Legal Business Name | PACIFIC MEDICAL IMAGING AND ONCOLOGY CENTER, INC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 707 S GARFIELD AVE SUITE B-001
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City | ALHAMBRA
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State | CA
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Zip | 91801-5859
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Country | US
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Telephone | 626-227-2727
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Fax | 626-227-2799
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Provider Business Mailing Address
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Address Line | PO BOX 65
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City | SIMI VALLEY
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State | CA
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Zip | 93062-0065
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Country | US
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Telephone | 805-577-8730
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Fax | 805-991-4065
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD CHAO
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Credential | MD
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Telephone | 626-227-2727
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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 | C2578418
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License Number State | CA
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