Basic Information
| Provider Information | |||||||||
| NPI: | 1083154827 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUANTUM MEDICAL RADIOLOGY OF CALIFORNIA, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3520 PIEDMONT RD NE STE 250 | ||||||||
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| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303051609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048702802 | ||||||||
| FaxNumber: | 7706669102 | ||||||||
| Practice Location | |||||||||
| Address1: | 1412 SAPPHIRE DR | ||||||||
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| City: | CARLSBAD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920111200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594554026 | ||||||||
| FaxNumber: | 7706669102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2017 | ||||||||
| LastUpdateDate: | 02/27/2017 | ||||||||
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| AuthorizedOfficialLastName: | FERRARO | ||||||||
| AuthorizedOfficialFirstName: | FRANCIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5594554026 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.