Individual
VICTORIA GANTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.T (R)(M)(F)
Contact information
Practice address
808 W 58TH ST, LOS ANGELES, CA 90037-3632
(323) 541-1600
Mailing address
526 E MAPLE AVE, EL SEGUNDO, CA 90245-2424
(701) 213-3648
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
RHM00069343
CA
2471M2300X
Mammography Radiologic Technologist
Primary
RHM00069343
CA
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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