SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC NPI 1417988221

NPI Information

NPI: 1417988221
Provider Name: SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
250 PROSPECT PL
SHARP CORONADO HOSPITAL
CORONADO, CA
ZIP 92118
Phone: (619) 522-3721
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SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC is a diagnostic radiology radiology in Coronado, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC NPI is 1417988221. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

250 PROSPECT PL
SHARP CORONADO HOSPITAL
CORONADO, CA
ZIP 92118-943
Phone: (619) 522-3721
Fax: (619) 522-3780

The provider's authorized official is Norman C. Chen .
The authorized official title is President/ceo and has the following contact phone number (858) 565-0950.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 4/21/2017.

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	207U00000X	Nuclear Medicine		B1982005164	CALIFORNIA	No
2	207UN0901X	Nuclear Medicine	Nuclear Cardiology	B1982005164	CALIFORNIA	No
3	207UN0902X	Nuclear Medicine	Nuclear Imaging & Therapy	B1982005164	CALIFORNIA	No
4	2085B0100X	Radiology	Body Imaging			No
5	2085N0700X	Radiology	Neuroradiology			No
6	2085N0904X	Radiology	Nuclear Radiology			No
7	2085R0204X	Radiology	Vascular & Interventional Radiology			No
8	2085P0229X	Radiology	Pediatric Radiology	B1982005164	CALIFORNIA	No
9	2085R0001X	Radiology	Radiation Oncology	B1982005164	CALIFORNIA	No
10	2085R0203X	Radiology	Therapeutic Radiology	B1982005164	CALIFORNIA	No
11	2085U0001X	Radiology	Diagnostic Ultrasound			No
12	208VP0000X	Pain Medicine	Pain Medicine	B1982005164	CALIFORNIA	No
13	208VP0014X	Pain Medicine	Interventional Pain Medicine	B1982005164	CALIFORNIA	No
14	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	GR0083813	MEDICAID	CALIFORNIA
2	HW529B	MEDICARE PIN	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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