Provider Demographics
NPI:1740973866
Name:DIEN, HAROLD JR (RT(R)(ARRT), RPA)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:DIEN
Suffix:JR
Gender:M
Credentials:RT(R)(ARRT), RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 MOHAVE DR
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-4813
Mailing Address - Country:US
Mailing Address - Phone:909-532-4019
Mailing Address - Fax:
Practice Address - Street 1:800 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4006
Practice Address - Country:US
Practice Address - Phone:909-450-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5744242471C3402X
CA21CA0919243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography