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Organization

MARIN PETCT IMAGING, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY KARMAN (MANAGING DIRECTOR)
(415) 722-1494
Entity
Organization

Contact information

Practice address
4000 CIVIC CENTER DR STE 110, SAN RAFAEL, CA 94903-5232
(401) 722-1494
Mailing address
4000 CIVIC CENTER DR STE 110, SAN RAFAEL, CA 94903-5232
(415) 722-1494

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
261QR0200X
Radiology Clinic/Center
Primary
293D00000X
Physiological Laboratory

Other

Enumeration date
07/24/2019
Last updated
12/07/2020
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