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General NPI Number Information
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NPI Number | 1740973866
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Entity Type | Individual
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Provider Name | HAROLD DIEN JR. R.T.(R)(ARRT), RPA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 800 E HIGHLAND AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4006
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Country | US
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Telephone | 909-450-0640
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 MOHAVE DR
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City | COLTON
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State | CA
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Zip | 92324-4813
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Country | US
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Telephone | 909-532-4019
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 574424
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 21CA0919
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License Number State | CA
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