Provider Demographics
NPI:1588764336
Name:SDI MOBILE DIAGNOSTIC SERVICES INC
Entity type:Organization
Organization Name:SDI MOBILE DIAGNOSTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-539-7300
Mailing Address - Street 1:4190 BONITA RD STE 211
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1340
Mailing Address - Country:US
Mailing Address - Phone:619-267-1305
Mailing Address - Fax:619-267-1389
Practice Address - Street 1:4190 BONITA RD STE 211
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-1340
Practice Address - Country:US
Practice Address - Phone:619-267-1305
Practice Address - Fax:619-267-1389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty