Provider Demographics
NPI:1619343050
Name:CENTRAL CALIFORNIA RADIOLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:CENTRAL CALIFORNIA RADIOLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LOEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-280-2047
Mailing Address - Street 1:365 HIGH SIERRA DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:CA
Mailing Address - Zip Code:93221-9505
Mailing Address - Country:US
Mailing Address - Phone:559-280-2047
Mailing Address - Fax:
Practice Address - Street 1:3610 W PACKWOOD AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5010
Practice Address - Country:US
Practice Address - Phone:559-280-2047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA652752085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty