RENAISSANCE RADIOLOGY MEDICAL GROUP, INC (NPI# 1912928565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912928565 |
Entity Type | Organization |
Organization Name | RENAISSANCE RADIOLOGY MEDICAL GROUP, INC |
Other Organization Name | RENAISSANCE RADIOLOGY MEDICAL GROUP, INC |
Practice Address |
1760 W 16th St San Bernardino CA 92411-1160 |
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 | 2008-06-24 |
Authorized Official Name | DR. MONIKA KIEF GARCIA (CEO PRESIDENT) |
Authorized Official Telephone | 9096208180 |
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 | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | GR0085397 | 05 | |
CA | RAILROAD MEDICARE | CG1263 | 01 |
Other Name | Type Code |
---|---|
Renaissance Radiology Medical Group, Inc | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144428350 | Renaissance Radiology Medical Group, Inc | Radiology | 2224 Medical Center Dr, Perris, CA 92571-2638 | 2007-07-10 |
1619951134 | Renaissance Radiology Medical Group, Inc | Radiology | 5451 Walnut Ave, Chino, CA 91710-2609 | 2005-11-30 |
Street Address |
1760 W 16TH ST |
City | SAN BERNARDINO |
State | CA |
Zip Code | 92411-1160 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497748081 | Vibra Hospital of San Bernardino, LLC | Rehabilitation Hospital | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2005-08-29 |
1457971566 | Jamie Lou Mejorada Sabellon | Speech-Language Pathologist | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2020-04-17 |
1306497144 | Megan Cherene | Speech-Language Pathologist | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2019-09-23 |
1467910331 | Austin Liao Lee | Pharmacist | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2019-03-08 |
1780182816 | Socal Rehab Consultants Inc | Physical Medicine & Rehabilitation | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2018-01-23 |
1134511249 | Rehabology | Physical Medicine & Rehabilitation | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2015-02-26 |
1033413604 | Kimberly A Johnson | Social Worker | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2010-12-22 |
1003040270 | Kar-wai Yung | Physical Medicine & Rehabilitation | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2009-05-04 |
1295798213 | Van Tze Chen | Physical Medicine & Rehabilitation | 1760 W 16th St, San Bernardino, CA 92411-1160 | 2006-04-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619537016 | Shaunice Renee Cox | Case Manager/Care Coordinator | 1604 Pennsylvania Street, San Bernardino, CA 92411 | 2019-06-18 |
1104327543 | Wilson Gomer M.d. Professional Medical Corporation | Clinic/Center | 1800 Western Ave Ste 103, San Bernardino, CA 92411 | 2018-02-21 |
1467883504 | Pedro Lynn Hayes | Nurse Practitioner | 1800 Medical Center Dr. #99, San Bernardono, CA 92411 | 2013-11-27 |
1184973505 | Maria G Villasenor Perez | Social Worker | 1002 W 7th St, San Bernardino, CA 92411 | 2012-08-30 |
1003140948 | Joe Mawad | Obstetrics & Gynecology | 1800 Western Ave Ste 204, San Bernardino, CA 92411 | 2009-09-24 |
1124255146 | Angie Bagheri Cook | Pediatrics | 565 N. Mount Vernon Ave, San Bernardino, CA 92411 | 2009-06-17 |
1770637365 | Paul Anthony Tenette | Pharmacist | Delta Drugs, 1666 N Medical Center Drive, San Bernadino, CA 92411 | 2007-01-22 |
1225117328 | Vinod Kumar Kaura | Internal Medicine | 1800 N Western Ave #303, San Bernardino, CA 92411 | 2006-11-02 |
1861582314 | Cecilia Talpa Quinones | Physician Assistant | 565 N. Mount Vernon Ave., San Bernardino, CA 92411 | 2006-10-13 |
1710075247 | Bramara Arya | Pediatrics | 1505 W. 17th Street, San Bernardino, CA 92411 | 2006-10-10 |
Find all providers in zip 92411 |
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 |
---|---|---|---|---|
1225669351 | Health Diagnostics of California A Professional Corporation | Radiology | 225 W Hospitality Ln Ste 100, San Bernardino, CA 92408-3244 | 2020-01-28 |
1477872919 | Beverly Radiology Medical Group | Radiology | 800 E Highland Ave, San Bernardino, CA 92404-4006 | 2010-05-24 |
1619451168 | Medx-imaging Services | Radiology | 284 E Highland Ave, San Bernardino, CA 92404-3706 | 2018-09-20 |
1619327798 | Faculty Physicians and Surgeons of Llusm | Radiology | 250 S G St, San Bernardino, CA 92410-3320 | 2016-06-20 |
1063873081 | Medx-imaging Services | Radiology | 1850 S Waterman Ave, Suite F, San Bernardino, CA 92408-2877 | 2016-03-18 |
1417324633 | Shahnawaz Ansari | Radiology | 2101 N Waterman Ave, San Bernardino, CA 92404-4836 | 2015-08-24 |
1841576097 | Walter Alan Osias | Radiology | 399 E 21st St, San Bernardino, CA 92404-4815 | 2011-11-01 |
1083943260 | Adam Coen | Radiology | 399 E 21st St, San Bernardino, CA 92404-4815 | 2009-12-16 |
1679735310 | Mri Diagnostics Inc | Radiology | 598 N F St, San Bernardino, CA 92410-3110 | 2008-06-25 |
1336325455 | Riverside Radiology Medical Group, Inc. | Radiology | 1884 Business Center Dr, San Bernardino, CA 92408-3457 | 2008-01-18 |
Find all providers in SAN BERNARDINO |
City | SAN BERNARDINO |
Zip Code | 92411 |
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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.