Organization
ST JOHNS REGIONAL IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN G DRAZBA (SENIOR V.P. & CHIEF ACCOUNTING OFCR)
(949) 282-6000
Entity
Organization
Contact information
Practice address
1700 N ROSE AVE, STE 110, OXNARD, CA 93030-3790
(805) 983-0883
(805) 983-1029
Mailing address
PO BOX 844350, LOS ANGELES, CA 90084-4350
(888) 685-3914
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470000913
RAILROAD MEDICARE
CA
05
—
DIAA00370
—
CA
Enumeration date
04/18/2006
Last updated
07/17/2013
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