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General NPI Number Information
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NPI Number | 1881811578
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Entity Type | Organization
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Legal Business Name | PRO SCAN MEDICAL IMAGING LLC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 07/16/2008
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Provider Practice Location Address
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Address Line | 929 JEFFERSON ST #D
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City | DELANO
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State | CA
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Zip | 93215-2296
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Country | US
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Telephone | 661-721-2658
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Fax | 661-721-8442
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Provider Business Mailing Address
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Address Line | 5200 WILDROSE LN
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-1600
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Country | US
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Telephone | 510-582-3792
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DON KLEIN
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Credential |
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Telephone | 510-582-3792
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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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