Organization
DELTA RADIOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL WOLCOTT (PRESIDENT)
(209) 339-7560
Entity
Organization
Contact information
Practice address
541 S HAM LN, SUITE B, LODI, CA 95242-3530
(209) 333-7426
(209) 333-7865
Mailing address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 334-4416
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0006152
—
CA
Enumeration date
03/20/2007
Last updated
09/12/2018
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