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General NPI Number Information
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NPI Number | 1457680555
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Entity Type | Organization
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Legal Business Name | ALL-N-1 MED CORP
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 12/18/2009
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Provider Practice Location Address
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Address Line | 9375 ARCHIBALD AVE STE 205
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-5729
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Country | US
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Telephone | 909-697-4171
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Fax | 909-614-7345
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Provider Business Mailing Address
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Address Line | 5001 WILSHIRE BLVD STE 112-623
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City | LOS ANGELES
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State | CA
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Zip | 90036-6104
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Country | US
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Telephone | 909-697-4171
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Fax | 909-614-7345
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALBERTO IAIA
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Credential | M.D.
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Telephone | 909-697-4171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G84826
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License Number State | CA
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