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General NPI Number Information
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NPI Number | 1588764336
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Entity Type | Organization
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Legal Business Name | SDI MOBILE DIAGNOSTIC SERVICES INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 4190 BONITA RD STE 211
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City | BONITA
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State | CA
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Zip | 91902-1340
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Country | US
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Telephone | 619-267-1305
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Fax | 619-267-1389
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Provider Business Mailing Address
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Address Line | 4190 BONITA RD STE 211
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City | BONITA
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State | CA
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Zip | 91902-1340
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Country | US
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Telephone | 619-267-1305
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Fax | 619-267-1389
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT M RIZO
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Credential |
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Telephone | 858-539-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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