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Source Diagnostics West Llc
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Lq, California
NPI 1598063133

Source Diagnostics West Llc is a Portable X-ray and/or Other Portable Diagnostic Imaging Supplier based in La Quinta, CA. Source Diagnostics West Llc practices in Lq, CA. The NPI Number for Source Diagnostics West Llc is 1598063133 and holds a License No. (California).

The current practice location address for Source Diagnostics West Llc is 49440 Via Pompa, Lq, CA and can be reached out via phone at 760-777-4352.

Location: 49440 Via Pompa, Lq, CA, 92253
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598063133
Provider Name
Source Diagnostics West Llc
Credential
Provider Entity Type
Organization
Address
49440 Via Pompa, Lq, CA, 92253
Phone Number
760-777-4352
Fax Number
Provider Enumeration Date
03/07/2011
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
49440 Via Pompa
City
Lq
State
California
Zip
92253
Phone Number
760-777-4352
Fax Number
person
Provider Business Mailing Address Details
Address
49440 Via Pompa
City
Lq
State
California
Zip
92253
Phone Number
760-777-4352
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist Cardiovascular
Speciality
Sonography
Taxonomy
246XS1301X
License No.
00080313 (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Sonography
Taxonomy
2471S1302X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Radiologic Technologist
Speciality
Vascular Sonography
Taxonomy
2471V0105X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Speciality
-
Taxonomy
335V00000X
License No.
()
Definition
A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed.
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