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General NPI Number Information
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NPI Number | 1609826684
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Entity Type | Organization
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Legal Business Name | LAMBERT RADIOLOGY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 12401 WASHINGTON BLVD
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City | WHITTIER
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State | CA
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Zip | 90602-1006
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Country | US
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Telephone | 562-698-0811
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Fax |
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Provider Business Mailing Address
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Address Line | 11721 WHITTIER BLVD SUITE 509
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City | WHITTIER
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State | CA
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Zip | 90601-3939
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Country | US
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Telephone | 562-698-0811
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM S M SHANAHAN
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Credential | M.D.
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Telephone | 562-698-0811
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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 | G41618
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License Number State | CA
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