Provider Demographics
NPI:1619263639
Name:RPN OF CALIFORNIA
Entity Type:Organization
Organization Name:RPN OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-553-3315
Mailing Address - Street 1:PO BOX 3501
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-0951
Mailing Address - Country:US
Mailing Address - Phone:877-553-3315
Mailing Address - Fax:858-225-1855
Practice Address - Street 1:3405 KENYON ST
Practice Address - Street 2:#202
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5003
Practice Address - Country:US
Practice Address - Phone:877-553-3315
Practice Address - Fax:858-225-1855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADIOLOGY PROVIDER NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)