MC CORMACK DENTAL XRAY INC. (NPI# 1558895243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558895243 |
| Entity Type | Organization |
| Organization Name | MC CORMACK DENTAL XRAY INC. |
| Practice Address |
395 N. Second Ave. Upland CA 91786 |
| Practice Telephone | 9099853030 |
| Practice Fax Number | 9099461200 |
| Mailing Telephone | 9099853030 |
| Mailing Fax Number | 9099461200 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | MRS. VALERIE J WELLS (PRESIDENT/X-RAY TECH) |
| Authorized Official Telephone | 9099214273 |
| Authorized Official Credential | LICENSED CALIFOR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471C3401X |
Radiologic Technologist Specialization: Computed Tomography |
RHP00040925 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
395 N. SECOND AVE. |
| City | UPLAND |
| State | CA |
| Zip Code | 91786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 2471C3401X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Computed Tomography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609489111 | Thomas Catelo | Radiologic Technologist | 1056 Calle Deceo, Chula Vista, CA 91913-3345 | 2020-08-25 |
| 1023406840 | Don Beevers | Radiologic Technologist | 118 College St, Hollister, CA 95023-3529 | 2014-12-31 |
| 1225393705 | Matthew J Kroona | Radiologic Technologist | 19012 Brookhurst St, Orange Coast Dental X-ray Lab, Huntingtn Bch, CA 92646-2552 | 2012-07-10 |
| 1568081842 | Jorge Kareem Sierra | Radiologic Technologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-04-16 |
| 1477108884 | Katalena Anastasia Saracino | Radiologic Technologist | 1901 W Lugonia Ave, Redlands, CA 92374-9703 | 2019-08-03 |
| 1215389762 | Roderick Durant | Radiologic Technologist | 10535 Hospital Way, Mather, CA 95655-4200 | 2016-07-08 |
| 1518141993 | Jr Montemayor | Radiologic Technologist | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2007-12-20 |
| 1508079690 | Heart Savers LLC | Radiologic Technologist | 4050 Barranca Pkwy, Suite # 170, Irvine, CA 92604-7706 | 2007-05-07 |
| 1699813170 | Elk Mountain Inc. | Radiologic Technologist | 1755 Court St, Redding, CA 96001-1721 | 2007-02-05 |
| 1225049042 | Los Gatos Community Ct, Inc. | Radiologic Technologist | 700 W Parr Ave, Suite F, Los Gatos, CA 95032-1442 | 2006-08-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.