Organization
IMAGE GUIDED THERAPEUTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TAYLOR M.D. (CEO)
(415) 750-4916
Entity
Organization
Contact information
Practice address
450 STANYAN ST, SAN FRANCISCO, CA 94117-1079
(415) 750-5770
Mailing address
FILE 1687 1801 W OLYMPIC BLVD, PASADENA, CA 91199-1687
(855) 735-7720
(415) 683-5591
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A8300022
CA
2085N0700X
Neuroradiology Physician
A83022
CA
2085N0904X
Nuclear Radiology Physician
A83022
CA
2085P0229X
Pediatric Radiology Physician
A83022
CA
2085R0202X
Diagnostic Radiology Physician
Primary
A83022
CA
2085R0204X
Vascular & Interventional Radiology Physician
A83022
CA
2085U0001X
Diagnostic Ultrasound Physician
A83022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0103430
—
CA
01
—
ZZZ03894Z
MEDICARE GROUP PROVIDER NUMBER
CA
Enumeration date
07/21/2006
Last updated
07/20/2015
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