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General NPI Number Information
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NPI Number | 1952468506
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Entity Type | Organization
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Legal Business Name | I V RADIOLOGY MEDICAL GROUP
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 1415 ROSS AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-4306
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Country | US
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Telephone | 760-339-7241
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Fax | 760-339-7249
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Provider Business Mailing Address
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Address Line | PO BOX 889
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City | WOODLAND HILLS
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State | CA
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Zip | 91365-0889
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Country | US
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Telephone | 805-375-8800
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Fax | 805-375-8900
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Authorized Official
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Title or Position | PARTNER OF IMPERIAL VALLEY RADIOLOG
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Name | JOHN R HADORN
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Credential | MD
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Telephone | 760-339-7241
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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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