DIGITAL & RADIOLOGIC IMAGING ASSOCIATES INC. A MEDICAL GROUP (NPI# 1891747200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891747200 |
| Entity Type | Organization |
| Organization Name | DIGITAL & RADIOLOGIC IMAGING ASSOCIATES INC. A MEDICAL GROUP |
| Practice Address |
17100 Euclid St Fountain Valley CA 92708-4004 |
| Mailing Address |
Po Box 3148 Mission Viejo CA 92690-1148 |
| Practice Telephone | 7149668041 |
| Mailing Telephone | 9493481105 |
| Mailing Fax Number | 9493481210 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-02-27 |
| Authorized Official Name | ELLIOTT J. WAGNER (PRESIDENT) |
| Authorized Official Telephone | 9493481105 |
| 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 |
Allopathic & Osteopathic Physicians | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0019852 | 05 | |
| CA | BLUE SHIELD | ZZZ36724Z | 01 |
| Street Address |
17100 EUCLID ST |
| City | FOUNTAIN VALLEY |
| State | CA |
| Zip Code | 92708-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386648319 | Kazuo Yamazaki | Pathology | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2005-06-08 |
| 1841837028 | Kevin Lo | Pharmacist | 17100 Euclid St, Fountain Valley, CA 92708-4043 | 2019-12-05 |
| 1275170524 | Dennis Anthony Cabrera | Pharmacist | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2019-12-05 |
| 1003462722 | Caitlyn Jeein Kim | Registered Nurse | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2019-08-18 |
| 1750946851 | Pauni Medical Inc | Specialist | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2019-05-03 |
| 1023672037 | Joseph Bui | Podiatrist | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2019-04-24 |
| 1528552353 | Frederica Yarborough | Nurse Practitioner | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2018-06-15 |
| 1952894982 | Phuong Tu Lam | Registered Nurse | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2018-06-13 |
| 1881197879 | Lori Akasaka | Social Worker | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2018-03-15 |
| 1124528104 | Sara Ajifu | Social Worker | 17100 Euclid St, Fountain Valley, CA 92708-4004 | 2018-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932716222 | Changing Directions Psychological Corporation | Psychologist | 17280 Newhope Street, Suite 4, Fountain Valley, CA 92708 | 2020-09-30 |
| 1124632757 | Neck & Back Pain Specialists, A Balta Chiropractic Corporation | Chiropractor | 10231 Slater Ave. #113, Fountain Valley, CA 92708 | 2020-09-01 |
| 1295205425 | Alexander Nee Dds Inc | Dentist | 337 S Rancho Santa Fe Rd, San Marcos, CA 92708 | 2018-11-30 |
| 1093293052 | Claudia Raquel Santos | Physical Therapist | 18384 Brookhurst Street, Fountain Valley, CA 92708 | 2018-08-01 |
| 1659864338 | Orange County Respiratory Physicians Corp | Internal Medicine | 18111 Brookhurst St Ste 4600, Fountain Valley, CA 92708 | 2018-06-07 |
| 1992297881 | Ereny Abdelmalak Metry | Pharmacist | 9064 Daffodil Ave, Fountain Valley, CA 92708 | 2018-06-06 |
| 1144746348 | Goose Pharma, LLC | Pharmacy | 18049 Magnolia Street, Fountain Valley, CA 92708 | 2017-08-18 |
| 1932622347 | Mayra Alejandra Guerra | Social Worker | 18350 Mt Langley St, Suite 200, Fountain Valley, CA 92708 | 2017-07-18 |
| 1942722129 | Graph Surgery Inc | Plastic Surgery | 10760 Warner Ave, Ste 201, Fountain Valley, CA 92708 | 2017-07-10 |
| 1871022277 | Cathy A Castagna-petersen | Counselor | 10529 Slater Avenue, Fountain Valley, CA 92708 | 2017-06-08 |
| Find all providers in zip 92708 | ||||
| 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 |
|---|---|---|---|---|
| 1649596479 | William Robert Grandolfo | Radiology | 17330 Brookhurst Street, Suite 315, Fountain Valley, CA 92708 | 2010-04-19 |
| 1134217359 | Peter Alan Willens | Radiology | 17815 Newhope Street, Suite S, Fountain Valley, CA 92708 | 2006-10-11 |
| 1295785921 | Sheldon L Zide | Radiology | 17100 Euclid Street, Radiology Department, Fountain Valley, CA 92708 | 2006-05-11 |
| 1720083447 | Anita Boorman | Radiology | 9930 Talbert Ave., Fountain Valley, CA 92708 | 2005-06-17 |
| 1902177785 | Newhope Imaging Center Inc | Radiology | 11190 Warner Ave, Suite 110, Fountain Valley, CA 92708-4019 | 2012-01-25 |
| 1285722488 | Ronald Max Frug | Radiology | 17815 Newhope Street, Suite S, Fountain Valley, CA 92708 | 2006-10-11 |
| 1396796264 | Dennis L Randall | Radiology | 17100 Euclid Street, Fountain Valley, CA 92708 | 2006-05-15 |
| 1114978277 | John S Belville | Radiology | 17100 Euclid St, Radiology Department, Fountain Valley, CA 92708-4004 | 2006-05-13 |
| 1699726182 | Robert M Turner | Radiology | 17100 Euclid St, Radiology Department, Fountain Valley, CA 92708-4004 | 2006-05-12 |
| 1538119540 | Mehran Tirandaz | Radiology | 17100 Euclid Street, Radiology Department, Fountain Valley, CA 92708 | 2006-05-11 |
| Find all providers in FOUNTAIN VALLEY | ||||
| City | FOUNTAIN VALLEY |
| Zip Code | 92708 |
Please comment or provide details below to improve the information on DIGITAL & RADIOLOGIC IMAGING ASSOCIATES INC. A MEDICAL GROUP.
| 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.