Organization
WESTERN IMAGING MARINA DEL REY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROB PETZOLD (DIRECTOR OF OPERATIONS)
(310) 736-4395
Entity
Organization
Contact information
Practice address
4640 ADMIRALTY WAY, SUITE 102, MARINA DEL REY, CA 90292-6621
(310) 736-4395
Mailing address
4640 ADMIRALTY WAY, SUITE 102, MARINA DEL REY, CA 90292-6621
(310) 736-4395
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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