Organization
EXCEL IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT TARACENA (CEO)
(323) 819-5053
Entity
Organization
Contact information
Practice address
18158 US HIGHWAY 18, APPLE VALLEY, CA 92307-2202
(323) 819-5053
Mailing address
11962 ALPINE DR, FONTANA, CA 92337-9072
(323) 819-5053
Taxonomy
Speciality
Code
Description
License number
State
2085U0001X
Diagnostic Ultrasound Physician
Primary
—
—
2471C3402X
Radiography Radiologic Technologist
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
03/03/2019
Last updated
03/04/2019
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