Organization · Type 2 NPI
ST Jude Radiology Medical Group Inc
Diagnostic Radiology Physician · Fullerton, CA
NPI number
1255819892
Active
Practice location
101 E Valencia Mesa Dr
Fullerton, CA 92835-3809
Fax (916) 533-0313
Mailing address
PO Box 26570
Fresno, CA 93729-6570
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician Primary | 2085R0202X | None listed |
| Vascular & Interventional Radiology Physician | 2085R0204X | None listed |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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About NPI 1255819892
ST Jude Radiology Medical Group Inc's National Provider Identifier is 1255819892, issued on Aug 6, 2018. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Fullerton, CA. The record was last updated on Feb 12, 2021.