RENAISSANCE RADIOLOGY MEDICAL GROUP, INC. (NPI# 1821019472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1821019472 |
Entity Type | Organization |
Organization Name | RENAISSANCE RADIOLOGY MEDICAL GROUP, INC. |
Practice Address |
5470 Jefferson Ave Chino CA 91710-3517 |
Mailing Address |
1902 Royalty Dr Suite 220 Pomona CA 91767-3030 |
Practice Telephone | 9096208180 |
Practice Fax Number | 9094696741 |
Mailing Telephone | 9096208180 |
Mailing Fax Number | 9094696741 |
Enumeration Date | 2006-07-21 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MRS. LINDA KAUFMAN (OFFICE MANAGER) |
Authorized Official Telephone | 9096208180 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | GR0008539E | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
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 |
1801870233 | Renaissance Radiology Medical Group, Inc. | Radiology | 26520 Cactus Ave, Moreno Valley, CA 92555-3927 | 2005-11-30 |
Street Address |
5470 JEFFERSON AVE |
City | CHINO |
State | CA |
Zip Code | 91710-3517 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568668739 | Renaissance Radiology Medical Group, Inc. | Clinic/Center | 5470 Jefferson Ave, Chino, CA 91710-3517 | 2007-06-25 |
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1922593789 | Christopher Armando Camarena | Assistant Behavior Analyst | 6062 Eucalyptus Ave, Chino, CA 91710 | 2018-06-25 |
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1629502554 | Jk Pharmacy Inc | Pharmacy | 5562 Philadelphia St, #110, Chino, CA 91710 | 2017-04-18 |
1801336680 | Altek Drugs Inc. | Pharmacy | 13085 Central Ave Ste 2, Chino, CA 91710 | 2017-02-28 |
1518405893 | Audrey Ronquillo | Behavior Technician | 800 Ferrari Ln, Suite 100, Ontario, CA 91710 | 2017-02-07 |
1952849556 | Jennifer Huynh | Behavior Technician | 800 Ferrari Ln Suite 100, Ontario, CA 91710 | 2017-02-03 |
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Taxonomy Code | 2085B0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Body Imaging |
A Radiology doctor of Osteopathy that specializes in Body Imaging. |
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
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---|---|---|---|---|
1730795881 | Valerie Rondone | Radiology | 2574 Raleigh Way, El Dorado Hills, CA 95762-6973 | 2020-09-23 |
1558997387 | Hope & Trust Trading LLC | Radiology | 318 W Colorado St #2, Glendale, CA 91204 | 2020-03-12 |
1417416124 | Adventist Health Physicians Network | Radiology | 155 Solano St Ste 101, Corning, CA 96021-3511 | 2019-03-13 |
1770068991 | Reham Aboughali | Radiology | 20349 Anza Ave Apt 27, Torrance, CA 90503-7410 | 2018-10-03 |
1962910513 | Excel Imaging Center Inc | Radiology | 13071 Brookhurst St Ste 100, Garden Grove, CA 92843-5514 | 2018-01-17 |
1467972315 | Radtech Services Inc | Radiology | 2826 Racine St, Simi Valley, CA 93065-2730 | 2017-06-22 |
1619363496 | Nathan Ashley | Radiology | 620 N Bonhill Rd, Los Angeles, CA 90049-2302 | 2015-04-08 |
1851709984 | Reveal Diagnostics, LLC | Radiology | 6080 Hellyer Ave, Suite 175, San Jose, CA 95138-1052 | 2014-08-01 |
1770912784 | William George Hayden | Radiology | 20 Ciervos Rd, Portola Valley, CA 94028-8107 | 2013-11-11 |
1215362942 | Reveal Diagnostics LLC | Radiology | 4217 Piedmont Avenue, Suite B, Oakland, CA 94611 | 2013-09-12 |
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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.