Individual
EDBAJAR RAMON VALDIVIESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RVT, RDCS, BS
Contact information
Practice address
1000 NEWBURY RD STE 270, THOUSAND OAKS, CA 91320-6445
(661) 309-5037
Mailing address
1000 NEWBURY RD, THOUSAND OAKS, CA 91320-6435
(661) 309-5037
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
102917
CA
2085R0204X
Vascular & Interventional Radiology Physician
102917
CA
2085U0001X
Diagnostic Ultrasound Physician
102917
CA
2471S1302X
Sonography Radiologic Technologist
Primary
102917
CA
2471V0105X
Vascular Sonography Radiologic Technologist
102917
CA
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
102917
CA
Other
Enumeration date
07/18/2023
Last updated
08/13/2024
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