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Organization
ST MARYS RADIOLOGY MEDICAL GROUP
Active
Organization
ST MARYS RADIOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY T VANLEY M.D. (PARTNER)
(562) 437-3833
Entity
Organization
Contact information
Practice address
1045 ATLANTIC AVE, SUITE 105, LONG BEACH, CA 90813-3408
(562) 437-3833
(562) 624-0741
Mailing address
1045 ATLANTIC AVE, SUITE 105, LONG BEACH, CA 90813-3408
(562) 437-3833
(562) 624-0741
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0003580
—
CA
Enumeration date
06/04/2006
Last updated
04/09/2014
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