Jackson W Penry (NPI# 1003055401, PAC ID# 7517144298) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1003055401 |
| PAC ID by PECOS | 7517144298 |
| Professional Enrollment ID | I20110606000608 |
| Full Name | Jackson W Penry |
| Organization Legal Name | SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC |
| Address |
4002 Vista Way Oceanside CA 92056-4506 |
| Phone Number | 7609407470 |
| Gender | M |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 2006 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 0143134353 |
| Number of Group Practice Members | 70 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050128 | TRI-CITY MEDICAL CENTER |
| 050115 | PALOMAR HEALTH DOWNTOWN CAMPUS |
| 050636 | POMERADO HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4002 Vista Way, Oceanside, CA 92056-4506 | 7609407470 | SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC |
| Organization Legal Name | SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC |
| Physicians | 75 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joshua I Rosenbaum | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 3020 Children's Way, San Diego, CA 92123-4223 |
| Margaret M Lee | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 7901 Frost St, San Diego, CA 92123-2701 |
| Donald J Ponec | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 2185 W Citracado Pkwy, Escondido, CA 92029-4159 |
| Michael L Puckett | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 751 Medical Ctr Ct, Chula Vista, CA 91911-6617 |
| Aaron M Smith | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 7901 Frost St, San Diego, CA 92123-2701 |
| Ankaj Khosla | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Christopher E Dory | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 751 Medical Ctr Ct, Chula Vista, CA 91911-6617 |
| Bassem A Georgy | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 555 E Valley Pkwy, Escondido, CA 92025-3048 |
| Hamed Aryafar | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 7901 Frost St, San Diego, CA 92123-2701 |
| Paul A Cripe | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 7901 Frost St, San Diego, CA 92123-2701 |
| Street Address |
4002 VISTA WAY |
| City | OCEANSIDE |
| State | CA |
| Zip | 92056-4506 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher D Olonan | Internal Medicine | Hospitalist Medicine Physicians of California - Oceanside | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Melinda W Martinez | Physician Assistant | Team Physicians of Southern California Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Marcus Contardo | Pathology | North Coast Pathology Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Ankaj Khosla | Diagnostic Radiology | San Diego Diagnostic Radiology Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| David A Antoun | Internal Medicine | Hospitalist Medicine Physicians of California - Oceanside | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Edward S Rotunda | Emergency Medicine | Team Physicians of Southern California Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Pengta A Chiang | Emergency Medicine | Team Physicians of Southern California Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Bonnie R Bobzien | Pathology | North Coast Pathology Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Melaku T Birhanie | Internal Medicine | Hospitalist Medicine Physicians of California - Oceanside | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Chad M Bernhardt | Emergency Medicine | Team Physicians of Southern California Medical Group Inc | 4002 Vista Way, Oceanside, CA 92056-4506 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alan M Krystal | Family Medicine | 2351 Cartegena Way, Oceanside, CA 92056-1726 | |
| Kathryn W Daly | Clinical Social Worker | 441 Ernest Ct, Oceanside, CA 92056-2408 | |
| Kaitlin J Smallwood | Clinical Social Worker | Mental Health Systems, Inc. | 3609 Ocean Ranch Blvd, Oceanside, CA 92056-2698 |
| Beth Forbes | Nurse Practitioner | 4743 Rising Glen Dr, Oceanside, CA 92056-3015 | |
| James William Farthing II | Chiropractic | 4750 Oceanside Blvd, Suite A17, Oceanside, CA 92056-3052 | |
| Linden J Burzell | Family Medicine | Graybill Medical Group Inc | 3142 Vista Way, Suite 100, Oceanside, CA 92056-3627 |
| James V Chabala | Family Medicine | Graybill Medical Group Inc | 3142 Vista Way, Suite 100, Oceanside, CA 92056-3627 |
| Kallie Arne Wikman | Physical Therapy | Rancho Physical Therapy Inc | 3142 Vista Way, Suite 101, Oceanside, CA 92056-3627 |
| Stephen D R Tinio | Family Medicine | Graybill Medical Group Inc | 3142 Vista Way, Suite 100, Oceanside, CA 92056-3627 |
| Jennifer T Lawrence | Physical Therapy | Rancho Physical Therapy Inc | 3142 Vista Way, Suite 101, Oceanside, CA 92056-3627 |
| Find all physicians in zip 92056 | |||
| City | OCEANSIDE |
| Zip Code | 92056 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | OCEANSIDE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Jackson W Penry.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.