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General NPI Number Information
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NPI Number | 1831173905
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Entity Type | Organization
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Legal Business Name | MEMRAD MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 OCEANGATE STE 1000
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City | LONG BEACH
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State | CA
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Zip | 90802
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Country | US
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Telephone | 562-590-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 100 OCEANGATE STE 1000
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City | LONG BEACH
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State | CA
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Zip | 90802
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Country | US
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Telephone | 562-590-7400
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Fax | 562-590-7452
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Authorized Official
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Title or Position | VICE PRESIDENT, OPERATIONS
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Name | MAUREEN BROOKS
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Credential |
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Telephone | 562-590-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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