Provider Demographics
NPI:1750519401
Name:RESOLUTION IMAGING MEDICAL CORPORATION
Entity type:Organization
Organization Name:RESOLUTION IMAGING MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:ALLEGRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-701-0905
Mailing Address - Street 1:2336 SANTA MONICA BLVD
Mailing Address - Street 2:#206
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2095
Mailing Address - Country:US
Mailing Address - Phone:310-828-7226
Mailing Address - Fax:310-496-0531
Practice Address - Street 1:2336 SANTA MONICA BLVD
Practice Address - Street 2:#206
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2095
Practice Address - Country:US
Practice Address - Phone:310-828-7226
Practice Address - Fax:310-496-0531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty