Organization · Type 2 NPI
Centrelake Medical Group, Inc.
Diagnostic Radiology Physician · Chino, CA
NPI number
1629636006
Active
Practice location
5562 Philadelphia St Ste 100
Chino, CA 91710-2482
Fax (909) 784-3760
Mailing address
3115 E Guasti Rd
Ontario, CA 91761-7853
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician Primary | 2085R0202X | None listed |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
About NPI 1629636006
Centrelake Medical Group, Inc.'s National Provider Identifier is 1629636006, issued on May 31, 2019. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Chino, CA. The record was last updated on May 24, 2021.