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Home Portable X-Ray
NPI 1396920047 · Portable X-ray and/or Other Portable Diagnostic Imaging Supplier · San Mateo, CA
Provider details
- NPI number
- 1396920047
- Entity type
- Organization
- Primary specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Charles Crouse, Owner Operator(650) 347-1880
- License
- RHT3605 (CA)
Specialties & taxonomies
- Portable X-ray and/or Other Portable Diagnostic Imaging SupplierPrimary335V00000XLicense RHT3605 (CA)
Suppliers
Practice location
30 So El Camino Real
Suite 109
San Mateo, CA 94401
Phone: (650) 347-1880
Fax: (650) 342-8379
Approximate (ZIP-level) locationGet directions
Mailing address
801 Maple St
San Mateo, CA 94402
Registry dates
- Enumerated
- 2007-12-31
- Last updated
- 2007-12-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.