Organization
SPORTS IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MAZOROS (ADMINISTRATOR)
(510) 456-4600
Entity
Organization
Contact information
Practice address
2675 STEVENSON BLVD, FREMONT, CA 94538-2323
(510) 795-6534
(510) 794-6822
Mailing address
39350 CIVIC CENTER DR STE 280, FREMONT, CA 94538-2331
(510) 456-4650
(510) 456-1006
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
42368
CA
Other
Enumeration date
11/03/2006
Last updated
06/20/2012
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