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NPI Code Detail

MEDICARE: OPTISON MOBILE ULTRASOUND

MEDICARE: OPTISON MOBILE ULTRASOUND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12471S1302XSonography Radiologic Technologist11677CA

General Provider Information

NPI Number : 1134144991
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTISON MOBILE ULTRASOUND
Provider Business Mailing Address
First Line : 174 ARGONNE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-3232
Country : US
Telephone Number : 562-439-7866
Fax Number : 877-428-1296
Provider Business Practice Location Address
First Line : 174 ARGONNE AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-3232
Country : US
Telephone Number : 562-439-7866
Fax Number : 877-428-1296
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MR. MARK CLEMENT ENDRES
Credential :
Telephone Number : 800-950-1161
Provider Enumeration Date : 07/13/2006
Last Update Date : 08/22/2020

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Directions to “OPTISON MOBILE ULTRASOUND ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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