Individual
MR. CONRADO OLALIA QUEMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRT
Contact information
Practice address
242 PREBLE DR, TUSTIN, CA 92780-3720
(714) 474-1149
Mailing address
17282 AMAGANSET WAY, TUSTIN, CA 92780-2506
(714) 474-1149
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
RHF00097408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RHF00097408
STATE OF CALIFORNIA RADIOLOGIC TECHNOLOGIST LICENSE
CA
Enumeration date
04/04/2018
Last updated
09/28/2024
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