1790749984 NPI number — RAMINDER K DHILLON-ACOSTA DO

Table of content: RAMINDER K DHILLON-ACOSTA DO (NPI 1790749984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790749984 NPI number — RAMINDER K DHILLON-ACOSTA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DHILLON-ACOSTA
Provider First Name:
RAMINDER
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790749984
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 72384
Provider Second Line Business Mailing Address:
RADIOLOGY ASSOCIATES OF CANTON, INC.
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44192
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-686-1837
Provider Business Mailing Address Fax Number:
330-686-5928

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 BANNOCK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-4507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-602-3192
Provider Business Practice Location Address Fax Number:
303-602-2719
Provider Enumeration Date:
04/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085B0100X , with the licence number:  34008689 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: 34008689 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 34008689 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X , with the licence number: 34008689 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: DR.0068825 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2649209 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00293814 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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