AEGIS PEDIATRIC IMAGING MEDICAL GROUP (NPI# 1376698548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376698548 |
| Entity Type | Organization |
| Organization Name | AEGIS PEDIATRIC IMAGING MEDICAL GROUP |
| Practice Address |
116 W Lime Ave Monrovia CA 91016-2841 |
| Mailing Address |
Po Box 190 Simi Valley CA 93062-0190 |
| Practice Telephone | 6263912014 |
| Practice Fax Number | 6269151209 |
| Mailing Telephone | 8055225940 |
| Mailing Fax Number | 8055226401 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARVIN NELSON (MANAGING PARTNER) |
| Authorized Official Telephone | 6263912014 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
116 W LIME AVE |
| City | MONROVIA |
| State | CA |
| Zip Code | 91016-2841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457592024 | Michael Y.l. Sun | Chiropractor | 116 W Lime Ave, Monrovia, CA 91016-2841 | 2009-03-11 |
| 1093991572 | Elizabeth W. Lee, M.d. Inc. | Specialist | 116 W Lime Ave, Monrovia, CA 91016-2841 | 2008-01-15 |
| 1639354855 | Arcuate Medical Group, A Professional Medical Corporation | Obstetrics & Gynecology | 116 W Lime Ave, Monrovia, CA 91016-2841 | 2008-01-07 |
| 1881881043 | Lime Avenue Health Care | Internal Medicine | 116 W Lime Ave, Monrovia, CA 91016-2841 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659914166 | Cynthia Marie Garcia | Behavior Technician | 612 S. Myrtle Ave., Suite 100, Monrovia, CA 91016 | 2019-10-28 |
| 1366096232 | Richard Compton Lamb | Health Educator | 825 S Myrtle Avenue, Monrovia, CA 91016 | 2019-07-30 |
| 1487208450 | Brendan Mai | Behavioral Analyst | 200 W Atara St, Monrovia, CA 91016 | 2019-07-29 |
| 1124672035 | Kathleen Marie Novell | Speech-Language Pathologist | 168 Poinsettia Avenue, Monrovia, CA 91016 | 2019-07-29 |
| 1932675931 | Rainbow Home Inc | Clinic/Center | 917 Monrovista Ave, Unit A, Monrovia, CA 91016 | 2018-10-17 |
| 1386136398 | Anh Van Ly | Physician Assistant | 116 W. Lime Ave, Monrovia, CA 91016 | 2018-06-05 |
| 1447741160 | Vera Lucia Mayorga | Licensed Psychiatric Technician | 816 Bonita St Apt B, Monrovia, CA 91016 | 2018-05-29 |
| 1518484146 | Carolyn Ann Burns | Home Health Aide | 1321 Orange Ave, Monrovia, CA 91016 | 2017-08-24 |
| 1962924357 | Ariela Ettie Emery | Genetic Counselor, MS | 655 East Huntington Drive, Monrovia, CA 91016 | 2017-07-07 |
| 1427578624 | Rebecca Niole Leal | Marriage & Family Therapist | 507 W Foothill Blvd, Monrovia, CA 91016 | 2017-06-20 |
| Find all providers in zip 91016 | ||||
| Taxonomy Code | 2085P0229X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Pediatric Radiology |
| A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |
| 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 |
|---|---|---|---|---|
| 1255702262 | Nicole Hughes | Radiology | 1975 4th St Rm C-1758l, San Francisco, CA 94158-2351 | 2015-10-16 |
| 1841633468 | Katherine Elizabeth Barton | Radiology | 4860 Y Street, Suite 3100, Sacramento, CA 95817-2309 | 2013-04-12 |
| 1609190578 | Brian Stewart Pugmire | Radiology | 1504 N Wishon Ave, Fresno, CA 93728-1827 | 2010-03-22 |
| 1427210160 | Juan C. Baez | Radiology | 11234 Anderson St Ste Mc-b623a, Loma Linda, CA 92354-2804 | 2008-06-25 |
| 1669657318 | University Childrens Medical Group | Radiology | 4650 W Sunset Blvd # 81, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1740489350 | Michael Frederick Fadell II | Radiology | 725 Welch Rd Rm 1890, Palo Alto, CA 94304-1601 | 2007-07-13 |
| 1649495029 | Alexander Anthony Cacciarelli | Radiology | 2198 Ladycliff Cir, Thousand Oaks, CA 91360-1978 | 2007-04-13 |
| 1386738870 | Cornelia Kaminsky | Radiology | 6430 Sunset Blvd, Los Angeles, CA 90027-6062 | 2006-10-02 |
| 1467472621 | Lane Frances Donnelly | Radiology | 300 Pasteur Dr # H1307, Stanford, CA 94305-2200 | 2006-07-20 |
| 1497710214 | Charles A. Gooding | Radiology | 5050 Parnassus Ave, San Francisco, CA 94143-0001 | 2006-04-18 |
| Find all providers with the same taxonomy | ||||
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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.