Organization
ARROWHEAD RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDRICK L ORR M.D. (PRESIDENT)
(909) 845-1121
Entity
Organization
Contact information
Practice address
600 N HIGHLAND SPRINGS AVE, BANNING, CA 92220-3046
(951) 845-1121
(951) 845-8904
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1520
(909) 580-1561
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
—
CA
2085R0202X
Diagnostic Radiology Physician
Primary
—
CA
2085R0204X
Vascular & Interventional Radiology Physician
—
CA
2085U0001X
Diagnostic Ultrasound Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0012311
—
CA
Enumeration date
09/14/2006
Last updated
08/12/2008
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