Provider Type Icon

OAK TREE MEDICAL CORPORATION NPI 1700980828


NPI Information

NPI: 1700980828
Provider Name: OAK TREE MEDICAL CORPORATION
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
751 CORDOVA STREET
SUITE #1
PASADENA, CA
ZIP 91101
Phone: (626) 577-2424
Get Directions

OAK TREE MEDICAL CORPORATION is a diagnostic radiology radiology in Pasadena, CA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. OAK TREE MEDICAL CORPORATION NPI is 1700980828. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

751 CORDOVA STREET
SUITE #1
PASADENA, CA
ZIP 91101-617
Phone: (626) 577-2424
Fax: (626) 577-2995

The provider's authorized official is Robert Edmund Wycoff .
The authorized official title is Administrative Director and has the following contact phone number (626) 577-3415.

The enumeration date for this NPI number is 9/11/2006 and was last updated on 8/28/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0204XRadiologyVascular & Interventional RadiologyCALIFORNIANo
22085R0202XRadiologyDiagnostic RadiologyCALIFORNIAYes

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
1W18399MEDICARE ID-TYPE UNSPECIFIED

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.