Doctor Name: | MR. MARIO BAGALLON |
NPI Number: | 1578725461 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RADIOLOGY TECH |
License Number: | RHP00089002 |
Business Practice Address: | 655 S Central Valley Hwy Shafter, CA - 932632790 |
Business Phone Number: | 6617469194 |
Business Fax Number: | 6617469197 |
Mailing Address: | 659 S Central Valley Hwy, SHAFTER |
State: | CA |
Postal Code: | 932632790 |
Phone Number: | 6614591913 |
Fax Number: | 6614591974 |
NPI Enumeration Date: | 07/01/2008 |
NPI Last Update Date: | 07/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | RHP00089002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |