Basic Information
| Provider Information | |||||||||
| NPI: | 1508009846 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALTA CT SERVICES A CALIFORNIA LIMITED PARTNERSHIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 LENNON LN STE 100 | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945982466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252967150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 DWIGHT WAY | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947042608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252967150 | ||||||||
| FaxNumber: | 9252967171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2009 | ||||||||
| LastUpdateDate: | 01/27/2011 | ||||||||
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| AuthorizedOfficialLastName: | FINCH | ||||||||
| AuthorizedOfficialFirstName: | IRA | ||||||||
| AuthorizedOfficialMiddleName: | JOHN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9252967150 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.