Basic Information
| Provider Information | |||||||||
| NPI: | 1104484492 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARAGON IMAGING AND INTERVENTION INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 414 HOLLY ST | ||||||||
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| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975202924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303554058 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2175 ROSALINE AVE | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960012549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5303554058 | ||||||||
| FaxNumber: | 5302293703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2019 | ||||||||
| LastUpdateDate: | 06/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | BEY | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | MD/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5303554058 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
No ID Information.