Organization
J. BRUCE JACOBS, MD, INC
Active
Other names
HUNTINGTON RADIOLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER USMANOV M.D. (PRESIDENT)
(323) 584-3333
Entity
Organization
Contact information
Practice address
2679 ZOE AVE, HUNTINGTON PARK, CA 90255-4144
(323) 584-3333
(323) 584-3336
Mailing address
2679 ZOE AVE, HUNTINGTON PARK, CA 90255-4144
(323) 584-3333
(323) 584-3336
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A21604
CA
Other
Enumeration date
12/13/2010
Last updated
01/30/2014
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