Organization
RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO
Active
Parent organization
RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO
Other names
Five Cities Medical Imaging
Organization subpart
Yes
Provider details
NPI number
Legal business name
RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO
Authorized official
DR. WILLIAM M. RUSSELL MD (MANAGING PARTNER)
(805) 461-7080
Entity
Organization
Contact information
Practice address
921 OAK PARK BLVD, STE 102, PISMO BEACH, CA 93449
(805) 779-7900
(805) 779-7910
Mailing address
PO BOX 2920, ATASCADERO, CA 93423-2920
(805) 461-7080
(805) 464-0243
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0009777
—
CA
Enumeration date
03/03/2006
Last updated
12/05/2007
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