Organization
RADIOLOGY MEDICAL GROUP OF SANTA CRUZ COUNTY INC
Active
Other names
Watsonville Community 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
75 NIELSEN STREET, WATSONVILLE, CA 95076
(831) 724-2236
(831) 724-8440
Mailing address
108 GREEN VALLEY ROAD, SUITE B, FREEDOM, CA 95019-3110
(831) 724-2236
(831) 724-8440
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ70814Z
—
CA
Enumeration date
08/04/2006
Last updated
03/27/2008
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