FULLERTON RADIOLOGY MEDICAL GROUP INC NPI 1861451858

NPI Information

NPI: 1861451858
Provider Name: FULLERTON RADIOLOGY MEDICAL GROUP, INC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1301 N ROSE DR
PLACENTIA, CA
ZIP 92870
Phone: (714) 993-2000
Get Directions

FULLERTON RADIOLOGY MEDICAL GROUP, INC is a diagnostic radiology radiology in Placentia, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. FULLERTON RADIOLOGY MEDICAL GROUP, INC NPI is 1861451858. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1301 N ROSE DR
PLACENTIA, CA
ZIP 92870-802
Phone: (714) 993-2000
Fax: (714) 524-4216

The provider's authorized official is Michael G Chan .
The authorized official title is President and has the following contact phone number (714) 526-2241.

The enumeration date for this NPI number is 3/20/2006 and was last updated on 8/26/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GR0006737	MEDICAID	CALIFORNIA
2	GR0006736	MEDICAID	CALIFORNIA
3	GR0006738	MEDICAID	CALIFORNIA
4	ZZZ642972	OTHER	CALIFORNIA	BLUE SHIELD OF CALIF
5	ZZZ74739Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIF
6	ZZZ74739Z	MEDICAID	CALIFORNIA
7	ZZZ75588Z	OTHER	CALIFORNIA	BLUE SHIELD OF CALIF
8	GR0006731	MEDICAID	CALIFORNIA

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

NPI Synchronization or Removal

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