Provider Demographics
NPI:1568665263
Name:DM RADIOLOGY
Entity type:Organization
Organization Name:DM RADIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-896-2178
Mailing Address - Street 1:PO BOX 5635
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-7635
Mailing Address - Country:US
Mailing Address - Phone:909-896-2178
Mailing Address - Fax:909-861-4995
Practice Address - Street 1:11922 SEACREST DR
Practice Address - Street 2:SUITE #B
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-1937
Practice Address - Country:US
Practice Address - Phone:909-896-2178
Practice Address - Fax:909-861-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35209171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty