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General NPI Number Information
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NPI Number | 1679119580
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Entity Type | Organization
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Legal Business Name | VANGUARD HEALTH
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 10557 JUNIPER AVE STE E2
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City | FONTANA
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State | CA
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Zip | 92337-7589
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Country | US
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Telephone | 909-356-4132
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Fax |
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Provider Business Mailing Address
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Address Line | 10557 JUNIPER AVE STE E2
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City | FONTANA
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State | CA
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Zip | 92337-7589
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Country | US
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Telephone | 909-356-4132
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Fax | 562-941-4767
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Authorized Official
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Title or Position | OWNER
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Name | MR. MARK IOELE
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Credential |
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Telephone | 909-356-4132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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