Organization
EL CAMINO RADIOLOGISTS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VOLNEY VANDALSEM III MD (PRESIDENT)
(650) 940-7044
Entity
Organization
Contact information
Practice address
2500 GRANT RD, MOUNTAIN VIEW, CA 94040-4302
(650) 940-7044
(650) 940-7134
Mailing address
PO BOX 6102, NOVATO, CA 94948-6102
(415) 884-3404
(415) 883-1836
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI9619
RAILROAD MEDICARE PIN
—
05
—
GR0010800
—
CA
Enumeration date
05/27/2006
Last updated
02/25/2008
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