Basic Information
| Provider Information | |||||||||
| NPI: | 1235161480 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL DOCTORS IMAGING INC A MEDICAL GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 492080 | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960492080 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302410473 | ||||||||
| FaxNumber: | 5302415377 | ||||||||
| Practice Location | |||||||||
| Address1: | 2020 COURT ST | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960011822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302431236 | ||||||||
| FaxNumber: | 5302438502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 12/28/2018 | ||||||||
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| AuthorizedOfficialLastName: | SLEPICKA | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO/CPA | ||||||||
| AuthorizedOfficialTelephone: | 5302431236 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.