Provider Demographics
NPI:1679867535
Name:FUTURE DIAGNOSTIC IMAGING
Entity type:Organization
Organization Name:FUTURE DIAGNOSTIC IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VETHODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-298-8477
Mailing Address - Street 1:7901 OAKPORT ST
Mailing Address - Street 2:2700
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-2015
Mailing Address - Country:US
Mailing Address - Phone:510-562-1440
Mailing Address - Fax:
Practice Address - Street 1:7901 OAKPORT ST
Practice Address - Street 2:2700
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-2015
Practice Address - Country:US
Practice Address - Phone:510-562-1440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10532471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty