RENAISSANCE RADIOLOGY MEDICAL GROUP, INC. (NPI# 1801870233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801870233 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE RADIOLOGY MEDICAL GROUP, INC. |
| Practice Address |
26520 Cactus Ave Moreno Valley CA 92555-3927 |
| Mailing Address |
1902 Royalty Dr Suite 220 Pomona CA 91767-3030 |
| Practice Telephone | 9096208180 |
| Practice Fax Number | 9096496741 |
| Mailing Telephone | 9096208180 |
| Mailing Fax Number | 9094696741 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2008-06-24 |
| Authorized Official Name | DR. MONIKA KIEF GARCIA (PRESIDENT CEO) |
| Authorized Official Telephone | 9096208180 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
CA | Allopathic & Osteopathic Physicians | |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
CA | Allopathic & Osteopathic Physicians | |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | CG1263 | 01 |
| CA | GR0085392 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821019472 | Renaissance Radiology Medical Group, Inc. | Radiology | 5470 Jefferson Ave, Chino, CA 91710-3517 | 2006-07-21 |
| 1598749921 | Renaissance Radiology Medical Group, Inc. | Radiology | 5000 San Bernardino St, Montclair, CA 91763-2326 | 2005-11-30 |
| 1932104908 | Renaissance Radiology Medical Group, Inc. | Radiology | 16850 Bear Valley Rd, Victorville, CA 92395-5794 | 2005-06-16 |
| 1437154697 | Renaissance Radiology Medical Group, Inc. | Radiology | 9041 Magnolia Ave, Ste 101, Riverside, CA 92503-3900 | 2005-06-15 |
| 1952306136 | Renaissance Radiology Medical Group, Inc. | Radiology | 1805 Medical Center Dr, San Bernardino, CA 92411-1217 | 2005-06-15 |
| 1316107550 | Renaissance Radiology Medical Group, Inc. | Radiology | 2000 Stadium Way, Los Angeles, CA 90026-2606 | 2008-06-11 |
| 1568668739 | Renaissance Radiology Medical Group, Inc. | Clinic/Center | 5470 Jefferson Ave, Chino, CA 91710-3517 | 2007-06-25 |
| 1134200983 | Renaissance Radiology Medical Group, Inc. | Radiology | 8599 Haven Ave., Suite 300, Rancho Cucamonga, CA 91730-4849 | 2006-10-18 |
| 1023092541 | Renaissance Radiology Medical Group, Inc. | Radiology | 3865 Jackson St, Riverside, CA 92503-3919 | 2005-11-30 |
| Street Address |
26520 CACTUS AVE |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92555-3927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477546414 | Menard Barruga | Pediatrics | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2005-08-24 |
| 1942816392 | Sheron Mathew | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-21 |
| 1669086237 | Brittany Noel Speer | Physician Assistant | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-09-01 |
| 1548873110 | Garrett Bao Kha Tran Long | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1639782063 | Yinxi Wu | Social Worker | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-08-25 |
| 1124636246 | Marie Therese Fonseca | Counselor | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-15 |
| 1396363545 | Jackson Helms | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-13 |
| 1588282024 | Adam Kreutzer | Orthopaedic Surgery | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1861010316 | Nicholas Bast | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-07-10 |
| 1699392449 | Xiao Song | Student in an Organized Health Care Education/Training Program | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2020-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817935 | Jillian Mika Ogata | Social Worker | Riverside University Health System, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2020-10-05 |
| 1114549144 | Providence Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 11165 Bonnie View Ave, Moreno Valley, CA 92555 | 2020-05-13 |
| 1720645096 | Shahida Nawaz | Non-emergency Medical Transport (VAN) | 26528 Primrose Way, Moreno Valley, CA 92555 | 2019-05-22 |
| 1679139828 | Moses Lee | Student in an Organized Health Care Education/Training Program | Department of Orthopaedic Surgery Rm. B2042 Ruhs-mc, 26520 Cactus Ave., Moreno Valley, CA 92555 | 2019-05-14 |
| 1215419668 | Johannes Wattimena | Counselor | 26624 Saffron Circle, Moreno Valley, CA 92555 | 2018-09-02 |
| 1437676939 | Aleksandra Vargas | Behavioral Analyst | 12549 Atherton Dr, Moreno Valley, CA 92555 | 2017-08-25 |
| 1063938603 | Anthony I Odimegwu | Nurse Practitioner | 26062 Bercaw Ct, Moreno Valley, CA 92555 | 2017-08-16 |
| 1073036703 | Karen Parker | Licensed Psychiatric Technician | 12944 Dolomite Lane, Moreno Valley, CA 92555 | 2017-07-25 |
| 1861923674 | Elena Vizcaino | Behavior Technician | 15670 Turnberry St, Moreno Valley, CA 92555 | 2017-03-23 |
| 1154744522 | Nancy Chivichon | Dietitian, Registered | 28648 Avenue Ave., Moreno Valley, CA 92555 | 2014-01-21 |
| Find all providers in zip 92555 | ||||
| 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 |
|---|---|---|---|---|
| 1578770806 | Nader Matloubi | Radiology | 12818 Heacock St Ste C2, Moreno Valley, CA 92553-3173 | 2007-05-17 |
| 1609022730 | Bryon Daniel Thomson | Radiology | 26520 Cactus Ave, Moreno Valley, CA 92555 | 2008-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902116 | Vesta Telemedicine Solutions, Pllc | Radiology | 833 Americana Way Unit 251, Glendale, CA 91210-1538 | 2020-11-04 |
| 1558960161 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 38209 47th St E Ste D, Palmdale, CA 93552-3113 | 2020-10-23 |
| 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 | ||||
| City | MORENO VALLEY |
| Zip Code | 92555 |
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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.