GREAT LAKES IMAGING S C NPI 1407406911

NPI Information

GREAT LAKES IMAGING S C is a diagnostic radiology radiology in El Segundo, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. GREAT LAKES IMAGING S C NPI is 1407406911. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2330 UTAH AVE STE 200
EL SEGUNDO, CA
ZIP 90245-817
Phone: (424) 290-8004

The provider's authorized official is Keegan Scanlon .
The authorized official title is Vice President and has the following contact phone number (424) 354-8724.

The enumeration date for this NPI number is 9/17/2019 and was last updated on 9/17/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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