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Organization
MOLECULAR IMAGING SORRENTO VALLEY, LLC
Active
Organization
MOLECULAR IMAGING SORRENTO VALLEY, LLC
Active
Other names
UCSD CENTER FOR MOLECULAR IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH C FREDERICK (CEO)
(858) 642-0032
Entity
Organization
Contact information
Practice address
11388 SORRENTO VALLEY RD, SUITE 100, SAN DIEGO, CA 92121-1345
(858) 373-2860
(858) 373-2865
Mailing address
9530 TOWNE CENTRE DR, SUITE 120, SAN DIEGO, CA 92121-1981
(858) 642-0032
(858) 642-0052
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
B2003020474
CA
Other
Enumeration date
05/05/2006
Last updated
07/24/2007
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