Source Diagnostics West LLC
NPI #1598063133 in Lq, California
Provider Information
- NPI Number
- 1598063133
- Entity Type
- Organization
- Organization Name
- Source Diagnostics West LLC
- Primary Specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Enumeration Date
- Mar 7, 2011
- Last Updated
- May 18, 2011
Practice Location
- Address
- 49440 VIA POMPA
- City
- Lq
- State
- California
- ZIP Code
- 92253
- Phone
- (760) 777-4352
Authorized Official
- Name
- MR. PAUL J MEZACAPA, RT. (R) MR, CT
- Title
- MANAGING MEMBER
- Phone
- (760) 777-4352
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist Cardiovascular - Sonography — Sonography |
| Radiologic Technologist - Vascular Sonography — Vascular Sonography |
| Radiologic Technologist - Sonography — Sonography |
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
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