Organization
ST. JUDE RADIOLOGY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY ELIZABETH STEELE (CREDENTIALING SPECIALIST)
(559) 455-4109
Entity
Organization
Contact information
Practice address
1177 ELMSFORD CT, CUPERTINO, CA 95014-4907
(858) 546-3800
Mailing address
PO BOX 940, NEWBURY PARK, CA 91319-0940
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
08/23/2019
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