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General NPI Number Information
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NPI Number | 1568751204
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Entity Type | Organization
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Legal Business Name | RJ ULTRASOUND, INC.
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 05/11/2015
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Provider Practice Location Address
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Address Line | 14650 ROSCOE BLVD SUITE 7
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4149
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Country | US
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Telephone | 818-855-1450
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Fax | 818-855-1451
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Provider Business Mailing Address
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Address Line | 14650 ROSCOE BLVD SUITE 7
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4149
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Country | US
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Telephone | 818-855-1450
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Fax | 818-855-1451
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JIMMY K CHANBONPIN
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Credential | MD
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Telephone | 818-895-3535
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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