Organization
RADIOLOGY MEDICAL GROUP OF SANTA CRUZ COUNTY INC
Active
Other names
Dominican Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH E AVERILL JR. MD (PRESIDENT)
(831) 476-1542
Entity
Organization
Contact information
Practice address
1555 SOQUEL DRIVE, SANTA CRUZ, CA 95065-1705
(831) 476-1542
(831) 464-8977
Mailing address
1661 SOQUEL DRIVE, BUILDING G, SANTA CRUZ, CA 95065-1709
(831) 476-1542
(831) 464-8977
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ73807Z
—
CA
Enumeration date
08/04/2006
Last updated
03/27/2008
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