CENTRELAKE MEDICAL GROUP, INC. (NPI# 1639137938) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639137938 |
| Entity Type | Organization |
| Organization Name | CENTRELAKE MEDICAL GROUP, INC. |
| Other Organization Name | CENTRELAKE IMAGING & ONCOLOGY |
| Practice Address |
3115 E Guasti Rd Ontario CA 91761-7853 |
| Practice Telephone | 9096350411 |
| Practice Fax Number | 9096350441 |
| Mailing Telephone | 9096350411 |
| Mailing Fax Number | 9096350441 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2018-04-25 |
| Authorized Official Name | MR. AMAR A LAPSI (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 9092126206 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
FNP34299 | CA | Ambulatory Health Care Facilities |
| N | 261QX0203X |
Clinic/Center Specialization: Oncology, Radiation |
FNP34299 | CA | Ambulatory Health Care Facilities |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
CA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Centrelake Imaging & Oncology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629636006 | Centrelake Medical Group, Inc. | Radiology | 5562 Philadelphia St Ste 100, Chino, CA 91710-2482 | 2019-05-31 |
| 1104293216 | Centrelake Medical Group, Inc. | Clinic/Center | 10226 Lakewood Blvd, Downey, CA 90241-2742 | 2015-08-24 |
| 1689800377 | Centrelake Medical Group, Inc. | Radiology | 1555 N Orange Grove Ave, Pomona, CA 91767-3811 | 2009-06-08 |
| Street Address |
3115 E GUASTI RD |
| City | ONTARIO |
| State | CA |
| Zip Code | 91761-7853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902418163 | Blue Oak Counseling Services, Inc. | Counselor | 3200 Guasti Rd #100, Ontario, CA 91761 | 2020-08-19 |
| 1578115986 | Hadel Awad | Behavior Technician | 1801 South Excise Ave, 116, Ontario, CA 91761 | 2019-07-15 |
| 1265902845 | Stephanie Escalante | Behavior Technician | 1801 S. Excise Ave. #116, Ontario, CA 91761 | 2018-11-27 |
| 1801395595 | Optimum Bio Lab Inc | Clinical Medical Laboratory | 1910 S Archibald Ave #d, Ontario, CA 91761 | 2018-02-07 |
| 1871010033 | Evelyn Esther Martinez | Case Manager/Care Coordinator | 1556 S. Sultana Ave., Ontario, CA 91761 | 2017-08-28 |
| 1750812525 | Building Bridges Christian Counseling | Marriage & Family Therapist | 3200 Guasti Road, Suite 100, Ontario, CA 91761 | 2017-03-23 |
| 1659829513 | Gregory J Musselman | Physician Assistant | 3550 E Philadelphia St Ste 150, Ontario, CA 91761 | 2016-09-20 |
| 1700332327 | Ramon Cardenas | Registered Nurse | 721 E. Banyan St., Ontario, CA 91761 | 2016-09-01 |
| 1023565660 | Breanna Gonzalez | Occupational Therapist | 3449 S. Wrangler Pl., Ontario, CA 91761 | 2016-09-01 |
| 1326491507 | Sasha Khawaja | Specialist/Technologist | 1500 So. Haven Ave, Ste 190, Ontario, CA 91761 | 2016-07-22 |
| Find all providers in zip 91761 | ||||
| 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 |
|---|---|---|---|---|
| 1487177200 | Ontario Interventional Center | Radiology | 1520 N Mountain Ave Ste 205, Ontario, CA 91762-1133 | 2017-07-24 |
| 1740236231 | Valley Radiology Medical Group | Radiology | 936 E Francis St, Ontario, CA 91761-5683 | 2006-05-26 |
| 1093773533 | John Gambino | Radiology | 2275 Laurel Dr, Ontario, OR 97914-4107 | 2006-05-03 |
| 1457319980 | David G Wood | Radiology | 964 W Idaho Ave, Snake River Radiology PCc, Ontario, OR 97914-2111 | 2006-05-03 |
| 1629397781 | Saint Alphonsus Medical Center - Ontario, Inc. | Radiology | 351 Sw 9th St, Ontario, OR 97914-2639 | 2010-05-27 |
| 1619070208 | Snake River Radiology PC | Radiology | 964 W Idaho Ave, Ontario, OR 97914-2111 | 2006-09-07 |
| 1578521936 | Robert T Yeager | Radiology | 964 W Idaho Ave, Snake River Radiology PC, Ontario, OR 97914-2111 | 2006-05-03 |
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| 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.