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Organization
ST. GERMAIN MOBILE IMAGING, INC.
Active
Organization
ST. GERMAIN MOBILE IMAGING, INC.
Active
Other names
ST. GERMAIN IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALBERTO MARIANO CODECIDO (PRESIDENT)
(661) 940-1384
Entity
Organization
Contact information
Practice address
43830 10TH ST W, LANCASTER, CA 93534-4826
(661) 940-1384
(661) 940-1382
Mailing address
PO BOX 8211, LANCASTER, CA 93539-8211
(661) 940-1384
(661) 940-1382
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
54843
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223458
F.D.A.
CA
05
—
IDTF00590
—
CA
Enumeration date
01/18/2007
Last updated
08/22/2020
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