Organization
I V RADIOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA LEE DENNIS (CREDENTIALING SPECIALIST)
(805) 375-8804
Entity
Organization
Contact information
Practice address
3224 FRESHWATER CRK, CHICO, CA 95973-2120
(858) 456-3800
Mailing address
1525 RANCHO CONEJO BLVD STE 201, THOUSAND OAKS, CA 91320-1448
(805) 375-8804
(770) 237-1429
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
10/11/2018
Last updated
03/24/2021
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