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General NPI Number Information
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NPI Number | 1740706175
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Entity Type | Organization
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Legal Business Name | DELAWARE RADIOLOGY ASSOCIATES PA
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 08/17/2017
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Provider Practice Location Address
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Address Line | 6 OMEGA DR BLDG L
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City | NEWARK
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State | DE
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Zip | 19713-2056
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Country | US
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Telephone | 302-738-9300
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Fax | 302-738-3791
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Provider Business Mailing Address
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Address Line | 1510 COTNER AVE
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City | LOS ANGELES
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State | CA
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Zip | 90025-3303
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Country | US
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Telephone | 310-445-2800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN V. CRUES
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Credential | MD
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Telephone | 310-445-2800
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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 | 120000
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License Number State | DE
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