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General NPI Number Information
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NPI Number | 1538256797
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL MEDICAL ULTRASOUND INC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1320 EATON RD
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City | SAN DIMAS
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State | CA
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Zip | 91773-2831
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Country | US
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Telephone | 909-592-6345
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Fax | 909-592-6156
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Provider Business Mailing Address
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Address Line | 1320 EATON RD
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City | SAN DIMAS
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State | CA
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Zip | 91773-2831
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Country | US
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Telephone | 909-592-6345
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Fax | 909-592-6156
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER LEVKOFF
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Credential |
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Telephone | 909-592-6345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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