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General NPI Number Information
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NPI Number | 1790832806
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Entity Type | Organization
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Legal Business Name | WASHINGTON VASCULAR DIAGNOSTICS, INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 39300 CIVIC CENTER DR SUITE 140
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City | FREMONT
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State | CA
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Zip | 94538-2338
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Country | US
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Telephone | 510-796-7036
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Fax | 510-796-7039
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Provider Business Mailing Address
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Address Line | 39300 CIVIC CENTER DR SUITE 140
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City | FREMONT
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State | CA
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Zip | 94538-2338
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Country | US
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Telephone | 510-796-7036
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Fax | 510-796-7039
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Authorized Official
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Title or Position | CEO
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Name | RICHARD DOUGLAS HUDSON
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Credential |
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Telephone | 510-796-7036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State |
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