Active NPI
Modern Nuclear, Inc.
- Nuclear Medicine Technology Radiologic Technologist
- La Habra, CA
National Provider Identifier
1972942241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Technology Radiologic Technologist
- License
- 5971-30
- Legal business name
- MODERN NUCLEAR, INC.
- Practice address
- 511 S Harbor Blvd Ste E
La Habra, CA 90631-9375 - Phone
- (562) 905-2244
- NPI assigned
- Jun 20, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Patrick James Laverty, CNMT
- Title
- Ceo/ Rso
- Phone
- (562) 905-2244
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Medicine Technology Radiologic Technologist | 2471N0900X | 5971-30 | CA | Primary |
Addresses
Primary practice location
511 S Harbor Blvd Ste E
La Habra, CA 90631-9375
Mailing address
511 S Harbor Blvd Ste E
La Habra, CA 90631-9375
Phone (562) 905-2244
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1371686400000",
"number": "1972942241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 S HARBOR BLVD STE E",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906319375",
"telephone_number": "562-905-2244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 S HARBOR BLVD STE E",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906319375",
"telephone_number": "562-905-2244"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MODERN NUCLEAR, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-20",
"last_updated": "2013-06-20",
"status": "A",
"authorized_official_last_name": "LAVERTY",
"authorized_official_first_name": "PATRICK",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "CEO/ RSO",
"authorized_official_telephone_number": "562-905-2244",
"authorized_official_credential": "CNMT"
},
"taxonomies": [
{
"code": "2471N0900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiologic Technologist, Nuclear Medicine Technology",
"state": "CA",
"license": "5971-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.