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Individual

GEORGE SO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3330 LOMITA BLVD, TORRANCE, CA 90505-5002
(310) 517-4675
Mailing address
PO BOX 190, SIMI VALLEY, CA 93062-0190
(805) 522-5940
(805) 522-6401

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G76849
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G768490
CA
Enumeration date
05/18/2006
Last updated
06/06/2008
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