Provider Demographics
NPI:1427220078
Name:ULTRATECH IMAGING, INC.
Entity Type:Organization
Organization Name:ULTRATECH IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:619-283-9794
Mailing Address - Street 1:PO BOX 600456
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92160-0456
Mailing Address - Country:US
Mailing Address - Phone:619-283-9794
Mailing Address - Fax:619-283-2944
Practice Address - Street 1:6381 RANCHO MISSION RD
Practice Address - Street 2:#2
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-2018
Practice Address - Country:US
Practice Address - Phone:619-283-9794
Practice Address - Fax:619-283-2944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDMS261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology