Organization
MOLECULAR IMAGING SORRENTO VALLEY, LLC
Active
Other names
UCSD CENTER FOR MOLECULAR IMAGING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH C FREDERICK (CEO)
(858) 642-0032
Entity
Organization
Contact information
Practice address
11388 SORRENTO VALLEY RD, SUITE 100, SAN DIEGO, CA 92121-1345
(858) 373-2860
(858) 373-2865
Mailing address
9530 TOWNE CENTRE DR, SUITE 120, SAN DIEGO, CA 92121-1981
(858) 642-0032
(858) 642-0052
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
B2003020474
CA
Other
Enumeration date
05/05/2006
Last updated
07/24/2007
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