Provider Demographics
NPI:1609489111
Name:CATELO, THOMAS (RT (R)(CT)ARRT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CATELO
Suffix:
Gender:M
Credentials:RT (R)(CT)ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1056 CALLE DECEO
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-3345
Mailing Address - Country:US
Mailing Address - Phone:484-892-0845
Mailing Address - Fax:
Practice Address - Street 1:1056 CALLE DECEO
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-3345
Practice Address - Country:US
Practice Address - Phone:484-892-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5724532471C3402X, 2471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography