MR. MARIO BAGALLON (NPI# 1578725461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578725461 |
| Entity Type | Individual |
| Full Name | MR. MARIO BAGALLON |
| Credential | RADIOLOGY TECH |
| Practice Address |
655 S Central Valley Hwy Shafter CA 93263-2790 |
| Mailing Address |
659 S Central Valley Hwy Shafter CA 93263-2790 |
| Practice Telephone | 6617469194 |
| Practice Fax Number | 6617469197 |
| Mailing Telephone | 6614591913 |
| Mailing Fax Number | 6614591974 |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2008-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | RHP00089002 | CA | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
655 S CENTRAL VALLEY HWY |
| City | SHAFTER |
| State | CA |
| Zip Code | 93263-2790 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700880622 | Agnes Gan Ong | Dentist | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2005-06-09 |
| 1518433382 | Omni Family Health | Clinic/Center | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2018-10-19 |
| 1407366313 | Yonui K Smith | Licensed Vocational Nurse | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2017-10-05 |
| 1447778378 | Rony-nichole Quintana | Nurse Practitioner | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2017-08-30 |
| 1528593530 | Amanda Bilik | Registered Nurse | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2017-04-27 |
| 1407225139 | Bhadraksh P Patel | Pharmacist | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2015-09-23 |
| 1194194878 | Tadeus Tarmidi | Pharmacist | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2015-09-23 |
| 1356737621 | Omni Family Health | Dental Hygienist | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2015-04-13 |
| 1760765085 | Hung Tony Pham | Physician Assistant | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2011-09-22 |
| 1114150703 | Manjot Kaur Dhaliwal | Physician Assistant | 655 S Central Valley Hwy, Shafter, CA 93263-2790 | 2009-08-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265958235 | Danessa Thorbrogger | Nurse Practitioner | 565 Kern Street, Shafter, CA 93263 | 2017-08-21 |
| 1376994533 | Shafter Urgent Care | Clinic/Center | 501 Munzer St Ste A, Shafter, CA 93263 | 2016-06-28 |
| 1821442658 | Huy Xuan Dang | Pharmacist | 825 Central Valley Hwy Ste A, Shafter, CA 93263 | 2016-04-18 |
| 1811362908 | Shafter Pediatrics | Pediatrics | 501 Munzer St, Suite C, Shafter, CA 93263 | 2015-12-01 |
| 1174769616 | Parrott Gordon & Associates L.p. | Dentist | 1110 E. Lerdo Highway, 200, Shafter, CA 93263 | 2009-01-06 |
| 1164696449 | Michael Komin Md Medical Corportion | Preferred Provider Organization | 1150 E Lerdo Hwy #c, Shafter, CA 93263 | 2008-04-17 |
| 1154526176 | Christine M Armstrong | Counselor | 151 Munzes St, Shefter, CA 93263 | 2007-06-19 |
| 1336327154 | Omni Family Health | Clinical Medical Laboratory | 659 S Central Valley Hwy, Shafter, CA 93263 | 2008-02-04 |
| 1477677821 | Joel N Cooper Physical Therapist Inc. | Physical Therapist | 142 E Tulare Ave, Shafter, CA 93263-1834 | 2007-03-19 |
| 1023060571 | Ggnsc Shafter Lp | Skilled Nursing Facility | 140 E Tulare Ave, Shafter, CA 93263-1834 | 2006-05-16 |
| Find all providers in zip 93263 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303665 | Jeffrey Chan | Radiologic Technologist | 2735 Ulloa St, San Francisco, CA 94116-2321 | 2020-07-17 |
| 1275098675 | California Mobile Imaging LLC | Radiologic Technologist | 3649 W Beechwood Ave Ste 106, Fresno, CA 93711-0693 | 2019-02-10 |
| 1669960068 | Tracey Saucier | Radiologic Technologist | 6342 Fallbrook Ave Ste 102, Woodland Hills, CA 91367-1613 | 2018-05-01 |
| 1972090652 | Souk Luangsrinhotha | Radiologic Technologist | 5021 Rosso Ct, Salida, CA 95368-9066 | 2018-04-18 |
| 1013454123 | Thanhtrang Dinh | Radiologic Technologist | 1725 W 17th St Rm 101e, Santa Ana, CA 92706-2316 | 2017-01-26 |
| 1427401512 | Ashim Haydar Ali | Radiologic Technologist | 8900 Thornton Rd Ste 24, Stockton, CA 95209-1820 | 2016-07-13 |
| 1952758963 | Kevin Schuman | Radiologic Technologist | 8042 Tuscany St, Fontana, CA 92336-3800 | 2016-05-19 |
| 1154782373 | Damian Dejesus | Radiologic Technologist | 2204 Auberry Ave, Bakersfield, CA 93304-7268 | 2016-03-15 |
| 1487023149 | Yasuhide Mikami | Radiologic Technologist | 710 E Keats Ave, Fresno, CA 93710-7022 | 2015-09-23 |
| 1518334630 | Hun Choe | Radiologic Technologist | 41 Muirfield, Trabuco Canyon, CA 92679-3421 | 2015-08-24 |
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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.