Organization
DELTA RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY GOLDBERG (CEO)
(209) 334-4416
Entity
Organization
Contact information
Practice address
1121 W VINE ST, SUITE 15, LODI, CA 95240-5137
(209) 334-4416
(209) 371-0119
Mailing address
PO BOX 15498, SACRAMENTO, CA 95851-0498
(559) 455-4000
(559) 455-4007
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ47020Z
—
CA
Enumeration date
08/05/2006
Last updated
12/11/2007
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