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General NPI Number Information
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NPI Number | 1699717496
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Entity Type | Organization
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Legal Business Name | RAMONA MEDICAL DIAGNOSTIC SERVICES INC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1516 MAIN ST 103
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City | RAMONA
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State | CA
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Zip | 92065-5242
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Country | US
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Telephone | 760-789-6118
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Fax | 760-788-2068
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Provider Business Mailing Address
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Address Line | 1516 MAIN ST 103
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City | RAMONA
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State | CA
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Zip | 92065
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Country | US
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Telephone | 760-789-6118
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Fax | 760-788-2068
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Authorized Official
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Title or Position | CEO
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Name | MR. CHARLES FRALEY
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Credential |
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Telephone | 760-789-6118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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