Organization
CARDIO VASCULAR IMAGING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS FAIREY RVT RCS BS (OWNER)
(530) 247-1880
Entity
Organization
Contact information
Practice address
1850 ROSALINE AVE, REDDING, CA 96001
(530) 247-1880
(530) 248-3340
Mailing address
PO BOX 492526, REDDING, CA 96049
(530) 247-1880
(530) 248-3340
Taxonomy
Speciality
Code
Description
License number
State
246X00000X
Cardiovascular Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ15665Z
MEDICARE- UNSPECIFIED
CA
Enumeration date
04/06/2007
Last updated
03/24/2010
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