Organization
VIP VEIN CENTER
Active
Parent organization
OMNIRAD MEDICAL GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
OMNIRAD MEDICAL GROUP, INC.
Authorized official
MRS. SUSAN M. ALLARDYCE (CFO)
(408) 371-0390
Entity
Organization
Contact information
Practice address
2410 SAMARITAN DR, SUITE 102, SAN JOSE, CA 95124-3909
(408) 371-8346
(408) 796-7787
Mailing address
2410 SAMARITAN DR, SUITE 102, SAN JOSE, CA 95124-3909
(408) 371-8346
(408) 796-7787
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A78415
CA
Other
Enumeration date
11/24/2010
Last updated
11/24/2010
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