Provider Demographics
NPI:1902173248
Name:ULTRASOUND LABORATORIES INC
Entity Type:Organization
Organization Name:ULTRASOUND LABORATORIES INC
Other - Org Name:SONOTECH IMAGING, SMARTHEALTH SCREENING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TECHNICAL DIRECTOR, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RVT, RDCS,RPHS
Authorized Official - Phone:408-829-6486
Mailing Address - Street 1:PO BOX 4864
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-0864
Mailing Address - Country:US
Mailing Address - Phone:408-829-6486
Mailing Address - Fax:408-890-4770
Practice Address - Street 1:305 SOUTH DRIVE, 7
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4207
Practice Address - Country:US
Practice Address - Phone:408-829-6486
Practice Address - Fax:408-890-4770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ULTRASOUND LABORATORIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-30
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
71989202K00000X, 2085U0001X, 246X00000X, 2471V0105X
CA719892471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty