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General NPI Number Information
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NPI Number | 1679867535
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Entity Type | Organization
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Legal Business Name | FUTURE DIAGNOSTIC IMAGING
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 7901 OAKPORT ST 2700
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City | OAKLAND
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State | CA
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Zip | 94621-2015
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Country | US
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Telephone | 510-562-1440
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Fax |
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Provider Business Mailing Address
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Address Line | 7901 OAKPORT ST 2700
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City | OAKLAND
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State | CA
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Zip | 94621-2015
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Country | US
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Telephone | 510-562-1440
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. SUNIL VETHODY
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Credential |
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Telephone | 408-298-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471M1202X
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Taxonomy Name | Magnetic Resonance Imaging Radiologic Technologist
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License Number | 1053
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License Number State | CA
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