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General NPI Number Information
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NPI Number | 1942010194
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Entity Type | Organization
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Legal Business Name | CLEARSCAN MOBILE XRAY LLC
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1774 FOREST CT
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City | CONCORD
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State | CA
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Zip | 94521-1147
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Country | US
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Telephone | 925-665-4127
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Fax |
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Provider Business Mailing Address
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Address Line | 1774 FOREST CT
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City | CONCORD
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State | CA
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Zip | 94521-1147
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Country | US
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Telephone | 925-665-4127
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHRISSIE GONZALES SMITH
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Credential |
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Telephone | 925-665-4127
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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