Provider Demographics
NPI:1134344146
Name:CURTIS & ASSOCIATES DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Entity type:Organization
Organization Name:CURTIS & ASSOCIATES DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JON
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:760-341-2723
Mailing Address - Street 1:45 355 MESA COVE
Mailing Address - Street 2:
Mailing Address - City:INDIAN WELLS
Mailing Address - State:CA
Mailing Address - Zip Code:92210-7140
Mailing Address - Country:US
Mailing Address - Phone:760-341-2723
Mailing Address - Fax:760-341-8574
Practice Address - Street 1:45 355 MESA COVE
Practice Address - Street 2:
Practice Address - City:INDIAN WELLS
Practice Address - State:CA
Practice Address - Zip Code:92210-7140
Practice Address - Country:US
Practice Address - Phone:760-341-2723
Practice Address - Fax:760-341-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG147192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty