Brandon Michael Ishaque (NPI# 1194085290, PAC ID# 0345505756) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1194085290 |
| PAC ID by PECOS | 0345505756 |
| Professional Enrollment ID | I20180605001332 |
| Full Name | Brandon Michael Ishaque |
| Organization Legal Name | ADVANCED IMAGING OF SOUTH BAY, INC. |
| Address |
4101 Torrance Blvd Torrance CA 90503-4607 |
| Phone Number | 3103035750 |
| Gender | M |
| Medical School | UNIVERSITY OF CALIFORNIA, UCLA SCHOOL OF MEDICINE |
| Graduation Year | 2007 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 8628080520 |
| Number of Group Practice Members | 20 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050353 | PROVIDENCE LITTLE COMPANY OF MARY MED CTR TORRANCE |
| 050078 | PROVIDENCE LITTLE CO OF MARY MED CTR SAN PEDRO |
| 050351 | TORRANCE MEMORIAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4101 Torrance Blvd, Torrance, CA 90503-4607 | 3103035750 | ADVANCED IMAGING OF SOUTH BAY, INC. |
| Organization Legal Name | ADVANCED IMAGING OF SOUTH BAY, INC. |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janak K Raval | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 5215 Torrance Blvd, Torrance, CA 90503-4009 |
| Glenn A Huettner | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Rooshin B Dalal | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Christopher E Smith | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Richard Ray Sullivan | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Lalitha Ramanna | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 5215 Torrance Blvd, Torrance, CA 90503-4009 |
| Hannah Nien | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Michael Stein | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 5215 Torrance Blvd, Torrance, CA 90503-4009 |
| Robert A Kolanz | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 5215 Torrance Blvd, Torrance, CA 90503-4009 |
| Lucas I Nishioka | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 5215 Torrance Blvd, Torrance, CA 90503-4009 |
| Street Address |
4101 TORRANCE BLVD |
| City | TORRANCE |
| State | CA |
| Zip | 90503-4607 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jin-hwa Simon | Hospitalist | Providence Medical Institute | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Farhan Husain | Internal Medicine | Providence Medical Institute | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Dwight A Wymore | Anesthesiology | South Bay Anesthesia Medical Group Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Allison E Arch | Neurology | Providence Medical Institute | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Sanghun Kim | Anesthesiology | South Bay Anesthesia Medical Group Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Sharline Kashfian-halimi | Anesthesiology | South Bay Anesthesia Medical Group Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Deepti H Chandran | Internal Medicine | Providence Medical Institute | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Cindy B Kim | Internal Medicine | Providence Medical Institute | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Glenn A Huettner | Diagnostic Radiology | Advanced Imaging of South Bay, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Eric Q Trieu | Hospice/palliative Care | Prohealth Partners, A Medical Group | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jared G Baker | Nurse Practitioner | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Jorge T Vournas | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Leonardo N Rodriguez | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Stefanie W Uechi | Nurse Practitioner | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Mona Marcella Colianno | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| John G Wallace Jr. | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Amber L Leonard | Nurse Practitioner | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Eugene B Baldridge | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Brianne A Shoji | Nurse Practitioner | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Evelyn G Lee | Emergency Medicine | Emergency Specialist Physicians Medical Associates, Inc | 4101 Torrance Bl, Torrance, CA 90503 |
| Find all physicians in zip 90503 | |||
| City | TORRANCE |
| Zip Code | 90503 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | TORRANCE + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Brandon Michael Ishaque.
| 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.