Provider Demographics
NPI:1356626675
Name:ULTRASOUND IMAGING SERVICES
Entity Type:Organization
Organization Name:ULTRASOUND IMAGING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:909-841-7241
Mailing Address - Street 1:1562 EL PASO DR
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3891
Mailing Address - Country:US
Mailing Address - Phone:909-841-7241
Mailing Address - Fax:951-734-5136
Practice Address - Street 1:1562 EL PASO DR
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-3891
Practice Address - Country:US
Practice Address - Phone:909-841-7241
Practice Address - Fax:951-734-5136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile