SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC (NPI# 1417988221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417988221 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC |
| Practice Address |
250 Prospect Pl Sharp Coronado Hospital Coronado CA 92118-1943 |
| Mailing Address |
Po Box 23540 San Diego CA 92193-3540 |
| Practice Telephone | 6195223721 |
| Practice Fax Number | 6195223780 |
| Mailing Telephone | 8585650950 |
| Mailing Fax Number | 8582441100 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2017-04-21 |
| Authorized Official Name | NORMAN C. CHEN (PRESIDENT/CEO) |
| Authorized Official Telephone | 8585650950 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207U00000X | Nuclear Medicine | B1982005164 | CA | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
B1982005164 | CA | Allopathic & Osteopathic Physicians |
| N | 207UN0902X |
Nuclear Medicine Specialization: Nuclear Imaging & Therapy |
B1982005164 | CA | Allopathic & Osteopathic Physicians |
| N | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
B198200516 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
B1982005164 | CA | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
B1982005164 | CA | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
B198200516 | CA | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
B198200516 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0083813 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134150949 | San Diego Diagnostic Radiology Medical Group Inc | Radiology | 3075 Health Center Dr, Sharp Memorial Outpatient Pavillions, San Diego, CA 92123-2773 | 2006-07-06 |
| 1205867017 | San Diego Diagnostic Radiology Medical Group Inc | Nuclear Medicine | 3020 Childrens Way, Children's Hospital and Health Center, San Diego, CA 92123-4223 | 2006-07-06 |
| 1326075375 | San Diego Diagnostic Radiology Medical Group Inc | Nuclear Medicine | 7901 Frost St, San Diego, CA 92123 | 2006-06-26 |
| Street Address |
250 PROSPECT PL SHARP CORONADO HOSPITAL |
| City | CORONADO |
| State | CA |
| Zip Code | 92118-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710989793 | Emergency Care Dynamics Inc | Emergency Medicine | 250 Prospect Pl, Coronado, CA 92118-1943 | 2005-08-10 |
| 1922611946 | Cep America - Neurology PC | Psychiatry & Neurology | 250 Prospect Pl, Coronado, CA 92118-1943 | 2020-08-28 |
| 1598395675 | Emergency Services Medical Corporation Coronado | Emergency Medicine | 250 Prospect Pl, Coronado, CA 92118-1943 | 2020-01-17 |
| 1013479476 | Sharp Coronado - Navy Resource Sharing | General Acute Care Hospital | 250 Prospect Pl, Coronado, CA 92118-1943 | 2019-04-04 |
| 1093280588 | Obel Borrajero | Nurse Practitioner | 250 Prospect Pl, Coronado, CA 92118-1943 | 2018-10-10 |
| 1538661285 | Jessica Morgan Bogle | Emergency Medicine | 250 Prospect Pl, Coronado, CA 92118-1943 | 2018-03-07 |
| 1932622156 | Johnny Garcia | Registered Nurse | 250 Prospect Pl, Coronado, CA 92118-1943 | 2017-07-19 |
| 1770036352 | Jessica Burley | Hospitalist | 250 Prospect Pl, Coronado, CA 92118-1943 | 2016-07-29 |
| 1780936989 | Hue Nguyen | Pharmacist | 250 Prospect Pl, Coronado, CA 92118-1943 | 2012-10-11 |
| 1649579202 | William M Wansa Medical Group | Emergency Medicine | 250 Prospect Pl, Coronado, CA 92118-1943 | 2011-03-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962997643 | Natalie Bailey | Dentist | 1010 8th St Ste A, Coronado, CA 92118 | 2018-06-26 |
| 1639661143 | Rebecca L. Frazier | Acupuncturist | 543 Orange Ave., Coronado, CA 92118 | 2018-05-31 |
| 1376046201 | Laura Mead Clapper | Pediatrics | 840 Adella Ave, Coronado, CA 92118 | 2018-03-16 |
| 1154836336 | Sarah R Peck | Occupational Therapy Assistant | 1530 Da Nang Dr Apt C, Coronado, CA 92118 | 2017-12-09 |
| 1962921395 | Jennifer Waidelich | Physical Therapist | 410 E Ave, Coronado, CA 92118 | 2017-09-18 |
| 1861843641 | Cliff Lovick I | Counselor | 1522 Frist St. Apt M 106, Coronada, CA 92118 | 2016-06-23 |
| 1184004871 | Melanie Villalobos | Dentist | 1001 B Ave #313, Coronado, CA 92118 | 2015-06-08 |
| 1801273479 | Jacqueline Brogan | Dermatology | 230 Prospect Pl Ste 260, Coronado, CA 92118 | 2015-05-02 |
| 1790184083 | Robert Cole Dunlap | Optometrist | 810 J Avenue, Coronado, CA 92118 | 2014-08-22 |
| 1235493602 | Jin Ah | Acupuncturist | 2425 Camino De Rio South, Suite 180, San Diego, CA 92118 | 2012-06-29 |
| Find all providers in zip 92118 | ||||
| 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 |
|---|---|---|---|---|
| 1346477577 | George Francis Unger | Radiology | 1770 Avenida Del Mundo, 1007, Coronado, CA 92118-3002 | 2009-06-15 |
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| 1003415613 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38925 Trade Center Dr Unit E, Palmdale, CA 93551-3655 | 2020-10-23 |
| 1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
| 1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
| 1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| 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.