Organization
JACARANDA RADIOLOGY
Active
Parent organization
ABRAHAM WILSON INC
Other names
Jacaranda Imaging Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
ABRAHAM WILSON INC
Authorized official
MISS LAKESHA SCOTT VN (ADMINISTRATIVE MANAGER)
(760) 956-2636
Entity
Organization
Contact information
Practice address
12021 JACARANDA AVE STE 104, HESPERIA, CA 92345-4978
(760) 956-5561
Mailing address
12021 JACARANDA AVE STE 104, HESPERIA, CA 92345-4978
(760) 956-5561
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2011
Last updated
08/05/2011
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