Organization · NPI-2

San Gabriel Radiology Medical Group

Radiology, Diagnostic Radiology · Monterey Park, CA

NPI number1205010709
StatusActive
Last updated in NPPESMar 1, 2012

Details

NPI
1205010709
Entity type
Organization (NPI-2)
Legal business name
San Gabriel Radiology Medical Group
Organization subpart
No
Enumeration date
Dec 20, 2007
Last updated
Mar 1, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0202X Radiology, Diagnostic RadiologyC33476CAYes

Practice location

555 N Garfield Ave
Monterey Park, CA 91754-1202

Phone 626-572-0914 · Fax 626-572-0914

Mailing address

555 N Garfield Ave
Monterey Park, CA 91754-1202

Phone 626-572-0914 · Fax 626-572-0914

Authorized official

Sean Patrick Whalen
Ceo, President, Director
6265720914

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