Organization
SAN JOAQUIN IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WILSON (ADMIN)
(209) 577-9900
Entity
Organization
Contact information
Practice address
1107 W POPLAR AVE, PORTERVILLE, CA 93257-5839
(209) 781-7242
Mailing address
4536 BROADWAY UNIT 906, SALIDA, CA 95368-2037
(209) 577-9900
(209) 577-1509
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
04/01/2019
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