Organization
DIAGNOSTIC IMAGING MED GRP OF KENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADELAIDA E BUSTOS MD (PARTNER CO OWNER)
(213) 413-7888
Entity
Organization
Contact information
Practice address
711 N ALVARADO STREET, SUITE 110, LOS ANGELES, CA 90026-4016
(213) 413-7888
(213) 413-5986
Mailing address
711 N ALVARADO STREET, SUITE 110, LOS ANGELES, CA 90026-4016
(213) 413-7888
(213) 413-5986
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A36348
CA
2085R0202X
Diagnostic Radiology Physician
A39381
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0029050
—
CA
Enumeration date
12/18/2006
Last updated
09/27/2007
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