MODESTO RADIOLOGICAL MEDICAL GROUP, INC (NPI# 1265973556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265973556 |
| Entity Type | Organization |
| Organization Name | MODESTO RADIOLOGICAL MEDICAL GROUP, INC |
| Practice Address |
6043 E Birdcage Ct Orange CA 92869-6015 |
| Mailing Address |
Po Box 7326 San Francisco CA 94120-7326 |
| Practice Telephone | 5594554009 |
| Practice Fax Number | 9165330313 |
| Mailing Telephone | 5594554009 |
| Mailing Fax Number | 9165330313 |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | MARK E MOORE (CFO/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 |
| 1073969838 | Modesto Radiological Medical Group, Inc | Radiology | 148 Beachview Ave, Santa Cruz, CA 95060-3008 | 2016-05-11 |
| 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 |
| Street Address |
6043 E BIRDCAGE CT |
| City | ORANGE |
| State | CA |
| Zip Code | 92869-6015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134677321 | Regional Diagnostic Imaging | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2016-09-15 |
| 1609398676 | St. Jude Radiology Medical Group, Inc. | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-07-12 |
| 1801325345 | Iv Radiology Medical Group | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790346401 | Artistic Smiles Dentistry | Clinic/Center | 2606 E. Chapman Ave., Orange, CA 92869 | 2019-06-24 |
| 1093233215 | Christine Wright | Physical Therapist | 406 S. Schug St, Orange, CA 92869 | 2017-09-07 |
| 1972025534 | Theresa M. Nakagawa | Marriage & Family Therapist | 7926 E. Deerfield Ln, Orange, CA 92869 | 2017-07-14 |
| 1679955801 | Lisa Moore | Nurse Anesthetist, Certified Registered | 1481 Meads, Orange, CA 92869 | 2015-06-24 |
| 1679960165 | Matthew Rivera | Specialist/Technologist | 360 N Rancho Santiago Blvd, Orange, CA 92869 | 2015-04-22 |
| 1780014183 | Sanaz Shahbandi | Dentist | 6449 East Saint Germain Cir., Orange, CA 92869 | 2013-11-21 |
| 1285973727 | Howard Leonard Rothfeder | Ophthalmology | 1567 Willow Wood Circle, Orange, CA 92869 | 2013-02-04 |
| 1730462409 | Luke Meier | Psychologist | 148 N Mine Canyon Rd Unit E, Orange, CA 92869 | 2011-09-20 |
| 1275825150 | S. La Verne Eng | Obstetrics & Gynecology | 351 Merelet Ln, Orange, CA 92869 | 2011-05-10 |
| 1497047757 | Eui San Cha | Internal Medicine | 2501 E Chapman Ave Ste 300, Orange, CA 92869 | 2011-05-05 |
| Find all providers in zip 92869 | ||||
| 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 |
|---|---|---|---|---|
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1154825172 | Taylor Wolfe | Radiology | 101 The City Dr S Bldg 20, Orange, CA 92868 | 2018-03-23 |
| 1134677321 | Regional Diagnostic Imaging | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2016-09-15 |
| 1609262047 | David Gedeon | Radiology | 101 The City Dr S Rm 115, Orange, CA 92868-3201 | 2015-04-13 |
| 1316382377 | Mark Duc Tran | Radiology | 101 The City Drive South, Bldg. 1, Room 0115, Route 140, Orange, CA 92868 | 2013-05-05 |
| 1396057576 | Waikeong Wong | Radiology | 101 The City Drive South, Route 140, Orange, CA 92868 | 2010-07-05 |
| 1134443211 | Kenneth Meng | Radiology | 431 S Batavia St Ste 103, Orange, CA 92868-3937 | 2010-03-18 |
| 1528380011 | Christopher Lee | Radiology | 101 The City Dr Rt 140, Orange, CA 92868 | 2010-02-24 |
| 1033151857 | Charles Steven Day | Radiology | 608 Strickland Drive, Orange, TX 77630-4717 | 2006-06-13 |
| 1952300592 | Joseph Barlin Tison | Radiology | 431 S Batavia St, Ste. 103, Orange, CA 92868-3936 | 2005-07-15 |
| Find all providers in ORANGE | ||||
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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.