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PACIFIC SHORES RADIOLOGY MEDICAL GROUP INC. NPI 1326104605


NPI Information

NPI: 1326104605
Provider Name: PACIFIC SHORES RADIOLOGY MEDICAL GROUP INC.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1025 S ANAHEIM BLVD
ANAHEIM, CA
ZIP 92805
Phone: (714) 563-2813
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PACIFIC SHORES RADIOLOGY MEDICAL GROUP INC. is a specialist in Anaheim, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PACIFIC SHORES RADIOLOGY MEDICAL GROUP INC. NPI is 1326104605. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1025 S ANAHEIM BLVD
ANAHEIM, CA
ZIP 92805-806
Phone: (714) 563-2813
Fax: (714) 502-2691

The provider's authorized official is Michael Poh .
The authorized official title is President and has the following contact phone number (310) 792-3914.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 11/1/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG60583CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11326104605MEDICAIDCALIFORNIA
2W19086MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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