QUEENS RADIOLOGY MEDICAL GROUP, INC. (NPI# 1154427987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154427987 |
| Entity Type | Organization |
| Organization Name | QUEENS RADIOLOGY MEDICAL GROUP, INC. |
| Practice Address |
1300 N Vermont Ave Department of Radiology Los Angeles CA 90027-6005 |
| Mailing Address |
Po Box 657 West Covina CA 91793-0657 |
| Practice Telephone | 3239134860 |
| Practice Fax Number | 3239134922 |
| Mailing Telephone | 9095954595 |
| Mailing Fax Number | 9095954365 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHN P LIN (CHAIRMAN) |
| Authorized Official Telephone | 3239134860 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| X | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0000080 | 05 |
| Street Address |
1300 N VERMONT AVE DEPARTMENT OF RADIOLOGY |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90027-6005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962498410 | Raed Bargout | Internal Medicine | 1300 N Vermont Ave, 401, Los Angeles, CA 90027-6005 | 2005-09-21 |
| 1447878095 | Michelle Valdez Labao | Nurse Practitioner | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2020-07-09 |
| 1265059638 | Parveen Kaur Md Inc | Internal Medicine | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2020-07-01 |
| 1336769728 | Anna Longuryan | Registered Nurse | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2020-04-25 |
| 1700410438 | Nicole Hilary Jaucian Valdez | Physician Assistant | 1300 N Vermont Ave, Los Angeles, CA 90027 | 2020-03-03 |
| 1457990087 | Ani Nairi Narinyan | Pharmacist | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2019-12-30 |
| 1356998272 | Pacifica Health Foundation | Preventive Medicine | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2019-08-26 |
| 1700341427 | Andrea Vasquez | Nurse Practitioner | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2019-02-06 |
| 1205391356 | Antoine Vernell Taylor Sr. | Emergency Medicine | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2019-02-04 |
| 1568936268 | Marianna Muradyan | Pharmacist | 1300 N Vermont Ave, Los Angeles, CA 90027-6098 | 2019-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1104450295 | Sarayana Sercarz | Marriage & Family Therapist | 4080 Woking Way, Los Angeles, CA 90027 | 2020-02-27 |
| 1457991143 | George Michaiel | Pediatrics | 4650 Sunset Blvd., Ms #54, Los Angeles, CA 90027 | 2020-01-09 |
| 1477199297 | Molly Rose Holmes | Marriage & Family Therapist | 3901 Los Feliz Boulevard, #303, Los Angeles, CA 90027 | 2019-11-27 |
| 1588206171 | Dental Help Solutions, LLC | Dentist | 4606 Hollywood Blvd, Suite A, Los Angeles, CA 90027 | 2019-10-15 |
| 1457905986 | Carmen L Ponce | Physical Therapy Assistant | 4867 Sunset Ave, Los Angeles, CA 90027 | 2019-08-01 |
| 1447729009 | Matthew Mendoza | Respiratory Therapist, Registered | 4867 Sunset Blvd, Los Angeles, Ca, Los Angeles, CA 90027 | 2018-11-13 |
| 1659856284 | Leticia Mendez | Nurse Practitioner | 1300 N Vermont Ave 606, Los Angeles, CA 90027 | 2018-09-29 |
| Find all providers in zip 90027 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619363496 | Nathan Ashley | Radiology | 620 N Bonhill Rd, Los Angeles, CA 90049-2302 | 2015-04-08 |
| 1518107952 | Universal Mri & Ct Inc | Radiology | 5757 Wilshire Blvd Suite #100, Los Angeles, CA 90036 | 2009-02-25 |
| 1215192950 | Conor Paul Meehan | Radiology | 10945 Le Conte Ave, Peter V Ueberroth Building, Ste 3371, Los Angeles, CA 90095-7206 | 2008-07-22 |
| 1285808089 | Anna Finkelstein | Radiology | 1500 San Pablo Street Dept of Radiology, Keck School of Medicine Usc Uh Second Floor Imaging, Los Angeles, CA 90033 | 2008-04-14 |
| 1841494614 | Harvard Diagnostic Imaging Center | Radiology | 3031 W Olympic Blvd, 200, Los Angeles, CA 90006-2522 | 2007-06-13 |
| 1033227640 | Ian A Levin | Radiology | 5455 Wilshire Boulevard, Suite 1120, Los Angeles, CA 90036-4201 | 2006-08-25 |
| 1770592768 | Gail Nalls | Radiology | 2001 Beverly Blvd Ste 218, Los Angeles, CA 90057-2403 | 2006-08-07 |
| 1487644027 | Pacific Alliance Medical Group | Radiology | 531 W College St, Los Angeles, CA 90012-2315 | 2005-10-25 |
| 1922461862 | Zachary Mark Haber | Radiology | 757 Westwood Plz, Los Angeles, CA 90095-2105 | 2016-03-29 |
| 1609253533 | Jean Michel Grillon | Radiology | 757 Westwood Plz Ste 1638, Los Angeles, CA 90095-9000 | 2015-04-29 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
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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.