Provider Demographics
NPI:1003963299
Name:OSTEOPOROSIS DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:OSTEOPOROSIS DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GENA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-445-1600
Mailing Address - Street 1:2773 HARRIS ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4866
Mailing Address - Country:US
Mailing Address - Phone:707-445-1600
Mailing Address - Fax:707-445-3778
Practice Address - Street 1:2773 HARRIS ST
Practice Address - Street 2:SUITE F
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4866
Practice Address - Country:US
Practice Address - Phone:707-445-1600
Practice Address - Fax:707-445-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0341522471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Single Specialty