Organization
DELTA RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY GOLDBERT (CEO)
(209) 334-4416
Entity
Organization
Contact information
Practice address
1617 N CALIFORNIA ST, SUITE 1A, STOCKTON, CA 95204-6117
(209) 948-6063
(209) 948-2661
Mailing address
PO BOX 15498, SACRAMENTO, CA 95851-0498
(559) 455-4000
(559) 455-4007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0006151
—
CA
Enumeration date
03/20/2007
Last updated
12/11/2007
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