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General NPI Number Information
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NPI Number | 1629021167
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Entity Type | Organization
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Legal Business Name | DESERT PET IMAGING, LLC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 1180 N INDIAN CANYON DR ROOM E-155
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City | PALM SPRINGS
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State | CA
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Zip | 92262-4800
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Country | US
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Telephone | 760-327-8000
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Fax | 760-327-8003
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Provider Business Mailing Address
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Address Line | 250 N WESTLAKE BLVD SUITE 220
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3700
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Country | US
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Telephone | 805-370-0200
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Fax | 805-370-0205
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Authorized Official
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Title or Position | COO
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Name | WAYNE K BALDWIN
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Credential |
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Telephone | 805-370-0200
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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 | EXEMPT
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License Number State | CA
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