Organization
MODERN NUCLEAR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK JAMES LAVERTY C.N.M.T., R.S.O. (C.E.O.)
(562) 905-2244
Entity
Organization
Contact information
Practice address
511 S HARBOR BLVD, BLDG E, LA HABRA, CA 90631-9375
(562) 905-2244
(562) 905-2024
Mailing address
511 S HARBOR BLVD, BLDG E, LA HABRA, CA 90631-9375
(562) 905-2244
(562) 905-2024
Taxonomy
Speciality
Code
Description
License number
State
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
Primary
RAML 5179-30
CA
Other
Enumeration date
07/26/2006
Last updated
06/12/2013
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