MODESTO RADIOLOGICAL MEDICAL GROUP, INC (NPI# 1134670656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134670656 |
Entity Type | Organization |
Organization Name | MODESTO RADIOLOGICAL MEDICAL GROUP, INC |
Practice Address |
8673 Julie Lynne Cir Tracy CA 95304-9207 |
Mailing Address |
Po Box 7326 San Francisco CA 94120-7326 |
Practice Telephone | 2093425946 |
Mailing Telephone | 5594554009 |
Mailing Fax Number | 9165330313 |
Enumeration Date | 2016-10-19 |
Last Update Date | 2017-01-06 |
Authorized Official Name | MARK E MOORE (COO) |
Authorized Official Telephone | 2093425946 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255872552 | Modesto Radiological Medical Group, Inc | Radiology | 3421 Deep Waters Ct, Simi Valley, CA 93065-0587 | 2017-03-20 |
1073969838 | Modesto Radiological Medical Group, Inc | Radiology | 148 Beachview Ave, Santa Cruz, CA 95060-3008 | 2016-05-11 |
1992170542 | Modesto Radiological Medical Group, Inc | Radiology | 728 Murphy Dr, San Mateo, CA 94402-3421 | 2015-12-08 |
1023482296 | Modesto Radiological Medical Group, Inc | Radiology | 6729 Monte Rd, San Luis Obispo, CA 93401-8050 | 2015-11-25 |
1861866022 | Modesto Radiological Medical Group, Inc | Radiology | 1648 Dalton Rd, Palos Verdes Estates, CA 90274-1835 | 2015-11-25 |
1760856934 | Modesto Radiological Medical Group, Inc | Radiology | 2132 Lysander Way, Roseville, CA 95661-3220 | 2015-11-25 |
1154808095 | Modesto Radiological Medical Group, Inc | Radiology | 3750 Whitman Cir, Carmel, CA 93923-8326 | 2018-07-24 |
1881198604 | Modesto Radiological Medical Group, Inc | Radiology | 1202 Chelshurst Way, Spring, TX 77379-3247 | 2018-03-19 |
1063953362 | Modesto Radiological Medical Group, Inc | Radiology | 1200 4th St, Apt 103, San Francisco, CA 94158-2392 | 2017-03-20 |
1265973556 | Modesto Radiological Medical Group, Inc | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-03-20 |
Street Address |
8673 JULIE LYNNE CIR |
City | TRACY |
State | CA |
Zip Code | 95304-9207 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770934226 | Tracy Dental Excellence, Chase Dental Group, Inc. | Dentist | 2858 West Grantline Rd, Tracy, CA 95304 | 2016-06-27 |
1396153474 | Reny Matthew | Pharmacist | 3010 W Grantline Road, Tracy, CA 95304 | 2014-08-01 |
1023286879 | Maneeza A Kulaly | Dentist | 2616 Pavilion Pkwy, Suite B, Tracy, CA 95304 | 2008-02-14 |
1447437892 | Norma Jean Paisley | Social Worker | 30000 Kasson Rd. #323, Tracy, CA 95304 | 2008-01-29 |
1811061641 | Katherine D Sanchez Dds Inc | Dentist | 2643 Naglee Rd, Tracy, CA 95304 | 2006-11-20 |
1851401467 | Costco Wholesale Corporation | Pharmacy | 3250 W Grant Line Rd, Tracy, CA 95304 | 2006-08-30 |
1942218128 | Adarsh Kaur | Dentist | 23500, Kasson Road, Tracy, CA 95304 | 2006-08-04 |
1982078630 | Janet Joanne Graham | Licensed Practical Nurse | 23500 Kasson Road, Tracy, CA 95304 | 2015-11-18 |
1215277207 | Dawn Bramley | Psychologist | 23500 Kasson Rd, Tracy, CA 95304 | 2013-02-27 |
1760670509 | Franklin Rafanan | Social Worker | 23500 Kasson Road, Tracy, CA 95304 | 2007-10-05 |
Find all providers in zip 95304 |
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 |
---|---|---|---|---|
1619948882 | Saral K Verma | Radiology | 443 W Eaton Ave, Tracy, CA 95376 | 2006-01-27 |
1063444768 | Mario P Sattah | Radiology | 1530 Bessie Ave, Suite 108, Tracy, CA 95376 | 2006-07-06 |
1669430518 | Robert M Lim | Radiology | 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 | 2006-05-02 |
1750341483 | Joseph Marshall | Radiology | 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 | 2006-03-25 |
1154312668 | Chull Sung Song | Radiology | 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 | 2005-11-03 |
1275523151 | Advanced Imaging of Tracy LLC | Radiology | 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 | 2005-10-24 |
1194715078 | Garth Howland Harley Jr. | Radiology | 1530 Bessie Ave, Suite 108, Tracy, CA 95376-3080 | 2005-10-24 |
1053301945 | Richard Michael Porzio | Radiology | 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 | 2005-10-24 |
1407846264 | Kyle Kai Yu | Radiology | 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 | 2005-10-24 |
1578553335 | Sam Peter Kokoris | Radiology | 1530 Bessie Ave, Ste 108, Tracy, CA 95376-3080 | 2005-10-24 |
Find all providers in TRACY |
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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.