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Organization
PENINSULA ULTRASOUND, MAMMOGRAPHY AND RADIOLOGY SERVICES MED GROUP INC
Active
Organization
PENINSULA ULTRASOUND, MAMMOGRAPHY AND RADIOLOGY SERVICES MED GROUP INC
Active
Other names
Peninsula Diagnostic Imaging Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETH KLEINER M.D (CEO)
(650) 343-1655
Entity
Organization
Contact information
Practice address
101 S SAN MATEO DR, SUITE 201, SAN MATEO, CA 94401-3819
(650) 343-1655
(650) 343-1686
Mailing address
101 S SAN MATEO DR, SUITE 201, SAN MATEO, CA 94401-3819
(650) 343-1655
(650) 343-1686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G46504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396878435
BK NPI
—
01
—
1801835079
SM NPI
—
01
—
1841297272
MPASTO NPI
—
01
—
1932326188
NLAI NPI
CA
Enumeration date
10/11/2006
Last updated
06/25/2015
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