CENTRELAKE MEDICAL GROUP INC NPI 1912572728

NPI Information

  • NPI: 1912572728
  • Provider Name: CENTRELAKE MEDICAL GROUP INC
  • Classification: Clinic/Center - 261QR0200X
  • Specialization: Radiology
  • Entity Type: Organization
  • Address: 1900 E LA PALMA AVE STE D
    ANAHEIM, CA
    ZIP 92805
  • Phone: (909) 242-7300

Map and Directions

Get Directions

NPI Details

CENTRELAKE MEDICAL GROUP INC is a radiology clinic center in Anaheim, CA. CENTRELAKE MEDICAL GROUP INC NPI is 1912572728. The provider is registered as an organization entity type.

The provider's business location address is:

1900 E LA PALMA AVE STE D
ANAHEIM, CA
ZIP 92805-647
Phone: (909) 242-7300
Fax: (909) 784-3760

The provider's authorized official is Tania Ceja .
The authorized official title is Site Manager and has the following contact phone number (909) 242-7300.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dxa bone density measurement of hip, pelvis, spine (HCPCS:77080)
  • Screening mammography (HCPCS:77067)

The enumeration date for this NPI number is 5/24/2021 and was last updated on 5/24/2021.

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
1261QR0200XClinic/CenterRadiologyYes

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
1GR0103950MEDICAIDCALIFORNIA

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: 3/30/2025

NPI Synchronization or Removal

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.

Previous NPI
Next NPI