RENAISSANCE RADIOLOGY MEDICAL GROUP INC NPI 1912928565

NPI Information

NPI: 1912928565
Provider Name: RENAISSANCE RADIOLOGY MEDICAL GROUP, INC

Doing Business As: RENAISSANCE RADIOLOGY MEDICAL GROUP, INC

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
1760 W 16TH ST
SAN BERNARDINO, CA
ZIP 92411
Phone: (909) 620-8180
Get Directions

RENAISSANCE RADIOLOGY MEDICAL GROUP, INC is a diagnostic radiology radiology in San Bernardino, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. RENAISSANCE RADIOLOGY MEDICAL GROUP, INC NPI is 1912928565. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Renaissance Radiology Medical Group, Inc.

The provider's business location address is:

1760 W 16TH ST
SAN BERNARDINO, CA
ZIP 92411-160
Phone: (909) 620-8180
Fax: (909) 469-6741

The provider's authorized official is Monika Kief Garcia .
The authorized official title is Ceo President and has the following contact phone number (909) 620-8180.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 6/24/2008.

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	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology	No
2	2085U0001X	Radiology	Diagnostic Ultrasound	No
3	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	GR0085397	MEDICAID	CALIFORNIA
2	ZZZ16516Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
3	CG1263	OTHER	CALIFORNIA	RAILROAD MEDICARE

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: 11/14/2023

NPI Synchronization or Removal

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