MODESTO RADIOLOGICAL MEDICAL GROUP, INC (NPI# 1073969838) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073969838 |
| Entity Type | Organization |
| Organization Name | MODESTO RADIOLOGICAL MEDICAL GROUP, INC |
| Practice Address |
148 Beachview Ave Santa Cruz CA 95060-3008 |
| Mailing Address |
1524 Mchenry Ave Ste 430 Modesto CA 95350-4500 |
| Practice Telephone | 5594554009 |
| Practice Fax Number | 9165330313 |
| Mailing Telephone | 5594554009 |
| Mailing Fax Number | 9165330313 |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |
| Authorized Official Name | MARK E MOORE (COO) |
| Authorized Official Telephone | 2093425946 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255872552 | Modesto Radiological Medical Group, Inc | Radiology | 3421 Deep Waters Ct, Simi Valley, CA 93065-0587 | 2017-03-20 |
| 1134670656 | Modesto Radiological Medical Group, Inc | Radiology | 8673 Julie Lynne Cir, Tracy, CA 95304-9207 | 2016-10-19 |
| 1992170542 | Modesto Radiological Medical Group, Inc | Radiology | 728 Murphy Dr, San Mateo, CA 94402-3421 | 2015-12-08 |
| 1023482296 | Modesto Radiological Medical Group, Inc | Radiology | 6729 Monte Rd, San Luis Obispo, CA 93401-8050 | 2015-11-25 |
| 1861866022 | Modesto Radiological Medical Group, Inc | Radiology | 1648 Dalton Rd, Palos Verdes Estates, CA 90274-1835 | 2015-11-25 |
| 1760856934 | Modesto Radiological Medical Group, Inc | Radiology | 2132 Lysander Way, Roseville, CA 95661-3220 | 2015-11-25 |
| 1154808095 | Modesto Radiological Medical Group, Inc | Radiology | 3750 Whitman Cir, Carmel, CA 93923-8326 | 2018-07-24 |
| 1881198604 | Modesto Radiological Medical Group, Inc | Radiology | 1202 Chelshurst Way, Spring, TX 77379-3247 | 2018-03-19 |
| 1063953362 | Modesto Radiological Medical Group, Inc | Radiology | 1200 4th St, Apt 103, San Francisco, CA 94158-2392 | 2017-03-20 |
| 1265973556 | Modesto Radiological Medical Group, Inc | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-03-20 |
| Street Address |
148 BEACHVIEW AVE |
| City | SANTA CRUZ |
| State | CA |
| Zip Code | 95060-3008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366940215 | Tiphanie Bowens | Counselor | 380 Encinal St., Suite 200, Santa Cruz, CA 95060 | 2018-01-25 |
| 1942714167 | Kyle Hardwick | Chiropractor | 203 River Street, Santa Cruz, CA 95060 | 2017-11-27 |
| 1972015741 | Nina Marie Francesconi | Acupuncturist | 110 Fern St Apt. C, Santa Cruz, CA 95060 | 2017-11-01 |
| 1679091870 | Laura Evelyn Rochelle | Counselor | 380 Encinal St., Suit 200, Santa Cruz, CA 95060 | 2017-09-07 |
| 1649797903 | Jessica Tarnoff | Counselor | 716 Ocean St., Santa Cruz, CA 95060 | 2017-08-28 |
| 1356862064 | Lakia Niema Queen | Counselor | 542 Ocean Street Suite K, Santa Cruz, CA 95060 | 2017-07-03 |
| 1023555992 | Allison Whitehead | Nurse Practitioner | 1080 Emeline Ave., County of Santa Cruz Health Services Agency, Santa Cruz, CA 95060 | 2017-01-30 |
| 1659827293 | Annabelle Drda | Marriage & Family Therapist | 303 Portero St, Santa Cruz, CA 95060 | 2016-09-01 |
| 1376999698 | Erin Liana Johnson | Counselor | 104 Walnut Avenue, Suite 208, Santa Cruz, CA 95060 | 2016-05-05 |
| 1659732097 | Daniel Ezekiel Contreras | Counselor | 1080 Emeline Building D, Santa Cruz, CA 95060 | 2016-03-13 |
| Find all providers in zip 95060 | ||||
| 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 |
|---|---|---|---|---|
| 1215179775 | Louis Russo Zwerling | Radiology | 1020 Laurent St, Santa Cruz, CA 95060-2506 | 2009-03-30 |
| 1588778252 | Leping Pu | Radiology | 1661 Soquel Dr Ste G, Santa Cruz, CA 95065 | 2006-08-18 |
| 1619987674 | Radiology Medical Group of Santa Cruz County Inc | Radiology | 1685 B Commercial Way, Santa Cruz, CA 95065-1703 | 2006-08-09 |
| 1992715601 | Radiology Medical Group of Santa Cruz County Inc | Radiology | 1545 Soquel Drive, Santa Cruz, CA 95065-1705 | 2006-08-08 |
| 1093714511 | Roy Elias Martinez | Radiology | 1661 Soquel Dr, Building G, Santa Cruz, CA 95065-1709 | 2005-07-18 |
| 1104119544 | Nicholas Thomas Rudnick | Radiology | 1661 Soquel Dr Ste G, Santa Cruz, CA 95065-1709 | 2011-05-18 |
| 1215253349 | Dustin Newell | Radiology | 1661 Soquel Dr Ste G, Santa Cruz, CA 95065-1709 | 2010-04-14 |
| 1043448194 | Ka-wah Tung | Radiology | 1661 Soquel Dr, Santa Cruz, CA 95065-1709 | 2009-06-29 |
| 1356582662 | Monica Harish | Radiology | 2025 Soquel Ave, Santa Cruz, CA 95062-1323 | 2009-03-16 |
| 1457597387 | Hoang Anh Tran Vo | Radiology | 1661 Soquel Dr Ste G, Santa Cruz, CA 95065 | 2008-12-24 |
| Find all providers in SANTA CRUZ | ||||
| City | SANTA CRUZ |
| Zip Code | 95060 |
Please comment or provide details below to improve the information on MODESTO RADIOLOGICAL MEDICAL GROUP, INC.
| 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.