Basic Information
| Provider Information | |||||||||
| NPI: | 1215389762 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DURANT | ||||||||
| FirstName: | RODERICK | ||||||||
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| Credential: | RT(R)(CT) | ||||||||
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| Mailing Information | |||||||||
| Address1: | 721 5TH ST | ||||||||
| Address2: | # 225 | ||||||||
| City: | WEST SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956052663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508346255 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10535 HOSPITAL WAY | ||||||||
| Address2: | |||||||||
| City: | MATHER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956554200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168437000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2016 | ||||||||
| LastUpdateDate: | 07/08/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471C3401X | 223436 | MN | Y | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Computed Tomography | 2471C3402X | RHF60823 | CA | N | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiography |
No ID Information.