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General NPI Number Information
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NPI Number | 1538427992
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Entity Type | Organization
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Legal Business Name | SIERRA MEDICAL IMAGING
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 1950 COMPTON AVE SUITE 112
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City | CORONA
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State | CA
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Zip | 92881-6471
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Country | US
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Telephone | 951-545-3527
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 COMPTON AVE SUITE 112
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City | CORONA
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State | CA
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Zip | 92881-6471
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Country | US
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Telephone | 951-545-3527
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL ALLEN MORTON
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Credential | R.D.M.S.
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Telephone | 951-545-3527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | 29216
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License Number State | CA
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