Individual
RANON C UDKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G55887
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G558870
—
CA
05
—
00G558871
—
CA
01
—
G55887
LICENSE
CA
Enumeration date
05/20/2006
Last updated
04/18/2024
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