Organization
ADVANCED IMAGING OF TRACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI L RONDOWANSKI (CREDENTIALING SPECIALIST)
(209) 342-2300
Entity
Organization
Contact information
Practice address
1530 BESSIE AVE, SUITE 108, TRACY, CA 95376-3080
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
69105
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ07670Z
BLUE SHIELD
CA
Enumeration date
10/24/2005
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us