Organization
CARDIAC MOLECULAR PET IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BALLOW (VICE PRESIDENT)
(702) 817-0375
Entity
Organization
Contact information
Practice address
2030 FOREST AVE STE 110, SAN JOSE, CA 95128-4833
(702) 817-0375
Mailing address
5944 MAHOGANY MOUNTAIN DR, LAS VEGAS, NV 89142-1685
(702) 817-0375
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
NV20161669909
NV
Other
Enumeration date
01/15/2018
Last updated
12/17/2021
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