Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 22, 2006
License(s)
G70312 (CA), G70312 (CA), 01091119A (IN)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1900 SULLIVAN AVE | Daly City, CA 94015-2200 | 650-691-6503 |
| MAILING | PO BOX 6102 | Novato, CA 94948-6102 | 415-884-3418 |
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