Organization
BLUEBEAM RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKRAM M HATTI M.D. (PRESIDENT)
(800) 922-6151
Entity
Organization
Contact information
Practice address
3902 EL CAJON BLVD STE A, SAN DIEGO, CA 92105-1016
(800) 922-6151
Mailing address
PO BOX 10662, FULLERTON, CA 92838-6662
(800) 922-6151
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A92712
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EK119A
MEDICARE PTAN
CA
Enumeration date
05/04/2010
Last updated
07/21/2022
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