| Organization Name: | MODERN NUCLEAR, INC. |
| NPI Number: | 1063851335 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICK LAVERTY (CEO/ RSO) |
| Mailing Address: | 511 S Harbor Blvd Ste E La Habra |
| State: | CA US |
| Postal Code: | 906319375 |
| Phone Number: | 5629052244 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 06/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471N0900X |
| License Number: | 5971-30 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Nuclear Medicine Technology |
| Taxonomy Definition: | |