Provider Demographics
NPI:1457087371
Name:AT FIRST SIGHT MOBILE ULTRASOUND
Entity Type:Organization
Organization Name:AT FIRST SIGHT MOBILE ULTRASOUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTINEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MARISELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-760-9801
Mailing Address - Street 1:240 N EAST PROMONTORY STE 200
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:240 N EAST PROMONTORY STE 200
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2950
Practice Address - Country:US
Practice Address - Phone:562-760-9801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory