Provider Demographics
NPI:1811490089
Name:S S B DIAGNOSTIC IMAGING GROUP INC
Entity type:Organization
Organization Name:S S B DIAGNOSTIC IMAGING GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:BERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-777-2986
Mailing Address - Street 1:619 S MIDWAY DR
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-4003
Mailing Address - Country:US
Mailing Address - Phone:754-777-2986
Mailing Address - Fax:888-511-2606
Practice Address - Street 1:911 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3428
Practice Address - Country:US
Practice Address - Phone:619-279-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No293D00000XLaboratoriesPhysiological Laboratory