Basic Information
| Provider Information | |||||||||
| NPI: | 1386865988 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | RON | ||||||||
| FirstName: | EYAL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7505 METRO BLVD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554393081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6125732200 | ||||||||
| FaxNumber: | 6125732274 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 SOUTHRIDGE DR | ||||||||
| Address2: | |||||||||
| City: | OAK PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 91377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8188658535 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2007 | ||||||||
| LastUpdateDate: | 06/28/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 87286 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 59975 | MN | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.