Organization
RENAISSANCE RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA KAUFMAN (OFFICE MANAGER)
(909) 620-8180
Entity
Organization
Contact information
Practice address
5470 JEFFERSON AVE, CHINO, CA 91710-3517
(909) 620-8180
(909) 469-6741
Mailing address
1902 ROYALTY DR, SUITE 220, POMONA, CA 91767-3030
(909) 620-8180
(909) 469-6741
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0008539E
—
CA
Enumeration date
07/21/2006
Last updated
08/22/2020
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