THURMOND-FEDERAL RADIOLOGY AND IMAGING MEDICAL GROUP, INC. (NPI# 1124054994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124054994 |
| Entity Type | Organization |
| Organization Name | THURMOND-FEDERAL RADIOLOGY AND IMAGING MEDICAL GROUP, INC. |
| Practice Address |
546 E Pine St Stockton CA 95204-5525 |
| Practice Telephone | 2094671000 |
| Practice Fax Number | 2094677335 |
| Mailing Telephone | 2094671000 |
| Mailing Fax Number | 2094677335 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2007-10-15 |
| Authorized Official Name | DR. WILLIAM AUBREY FEDERAL (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2094671000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
546 E PINE ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-5525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508836453 | Charles Allen Stillman | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2006-01-24 |
| 1568756096 | Valley Mri and Radiology Inc | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2011-06-01 |
| 1659413664 | William Aubrey Federal | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2007-02-13 |
| 1053341669 | Daniel Scott Dietrich | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2006-07-03 |
| 1598700171 | Valley Mri Center | Clinic/Center | 546 E Pine St, Stockton, CA 95204-5525 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366832313 | Quantum Medical Radiology of California, PC | Radiology | 10128 Tank House Dr, Stockton, CA 95209-4335 | 2015-01-29 |
| 1356538201 | Stockton Diagnostic Imaging | Radiology | 1801 E March Ln Ste A130, Stockton, CA 95210-6650 | 2007-09-25 |
| 1508836453 | Charles Allen Stillman | Radiology | 546 E Pine St, Stockton, CA 95204-5525 | 2006-01-24 |
| 1871584227 | David W H Wong | Radiology | 5832 Saint Andrews Dr, Stockton, CA 95219-1930 | 2005-11-03 |
| 1255721213 | Solano Diagnostics Partners, A California Limited Partnership | Radiology | 10128 Tank House Dr, Stockton, CA 95209-4335 | 2015-01-29 |
| 1578844973 | Rad Physicians Medical Corporation, Inc | Radiology | 1800 N California St, Stockton, CA 95204-6019 | 2011-08-30 |
| 1639499239 | Delta Radiology Medical Group Inc | Radiology | 10200 Trinity Pkwy, # 204, Stockton, CA 95219-7286 | 2010-06-04 |
| 1891936795 | Pavan Khanna | Radiology | 1800 N California St, Stockton, CA 95204-6019 | 2009-03-23 |
| 1730353137 | Delta Radiology Medical Group, Inc. | Radiology | 2320 N California St, Suite 3, Stockton, CA 95204-5509 | 2008-04-16 |
| 1013181411 | Delta Radiology Medical Group, Inc. | Radiology | 1617 N California St, Suite 1a, Stockton, CA 95204-6117 | 2008-04-16 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.