Samuel Salen (NPI# 1629073804, PAC ID# 1254231814) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1629073804 |
| PAC ID by PECOS | 1254231814 |
| Professional Enrollment ID | I20051103001085 |
| Full Name | Samuel Salen |
| Organization Legal Name | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| Address |
136 Emerson St Upland CA 91784-1337 |
| Phone Number | 9517860801 |
| Gender | M |
| Credential | MD |
| Medical School | JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY |
| Graduation Year | 1965 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 0648311548 |
| Number of Group Practice Members | 37 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 030084 | CHINLE COMPREHENSIVE HEALTH CARE FACILITY |
| 021309 | BRISTOL BAY AREA HEALTH CORPORATION |
| 030078 | PHOENIX INDIAN MEDICAL CENTER |
| 320006 | EASTERN NEW MEXICO MEDICAL CENTER |
| 320059 | NORTHERN NAVAJO MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 12700 Centerville Rd, Chico, CA 95928-8328 | 5308950926 | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| Off Hwy 191 and Hospital Rd, Chinle, AZ 86503-2147 | 9286747166 | DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY |
| 6000 Kanakanak Rd, Dillingham, AK 99576 | 90784252016217 | BRISTOL BAY AREA HEALTH CORPORATION |
| 7595 County Rd, Suite 236, Findlay, OH 45840-8738 | 4194271984 | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 5057221000 | DHHS PHS NAIHS GALLUP INDIAN MEDICAL CENTER |
| Main St, Koliganek, AK 99576 | 90784252016217 | BRISTOL BAY AREA HEALTH CORPORATION |
| 338 Lowell Ave, Mill Valley, CA 94941-3845 | 9517860801 | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| 4212 N 16th St, Phoenix, AZ 85016-5319 | 6022631200 | DHEW IND HLTH SV HLTH SVS AND MNTL HLTH ADM |
| Navajo Route 4, Pinon, AZ 86510-2147 | 9287253220 | DHHS PHS NAIHS CHINLE COMPREHENSIVE HEALTH CARE FACILITY |
| Highway 491, Shiprock, NM 87420-0160 | 5053686050 | DHHS PHS NAIHS SHIPROCK HOSPITAL |
| 3101 W Us Hwy 224, Tiffin, OH 44883-8305 | 4194487424 | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| 136 Emerson St, Upland, CA 91784-1337 | 9517860801 | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| Organization Legal Name | ON-LINE RADIOLOGY MEDICAL GROUP INC |
| Physicians | 31 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Louise Huck | Diagnostic Radiology | On-line Radiology Medical Group Inc | 7904 Waterfalls Ave, Las Vegas, NV 89128-6709 |
| Joshua R Albrektson | Diagnostic Radiology | On-line Radiology Medical Group Inc | 750 S Spaulding Ave, Apt 120, Los Angeles, CA 90036-4554 |
| Charles M Davis | Diagnostic Radiology | On-line Radiology Medical Group Inc | 1019 Hwy 17 S, North Myrtle Beach, SC 29582-3702 |
| Jose Ospina | Diagnostic Radiology | On-line Radiology Medical Group Inc | 315 Goldenrod Ave, Corona Del Mar, CA 92625-2905 |
| Vinod Nigam | Diagnostic Radiology | On-line Radiology Medical Group Inc | 7704 Belvedere Pl, Rancho Cucamonga, CA 91730-6664 |
| Sandra J Althaus | Diagnostic Radiology | On-line Radiology Medical Group Inc | 7320 Bachelors Button Dr, Las Vegas, NV 89131-4119 |
| Kamiar Massrour | Diagnostic Radiology | On-line Radiology Medical Group Inc | 7310 N Shadow Mountain Rd, Paradise Valley, AZ 85253-3302 |
| Jason Lue | Diagnostic Radiology | On-line Radiology Medical Group Inc | 1508 N Mercury Dr, Los Angeles, CA 90042-2275 |
| Laiandrea M Stewart | Diagnostic Radiology | On-line Radiology Medical Group Inc | 5605 Saddlewood Ln, Brentwood, TN 37027-4837 |
| Alix Vincent | Diagnostic Radiology | On-line Radiology Medical Group Inc | 1246 W 155th St, Gardena, CA 90247-4011 |
| Street Address |
136 EMERSON ST |
| City | UPLAND |
| State | CA |
| Zip | 91784-1337 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer M Bowen | Clinical Social Worker | Wellqor Psychological Services of California, PC | 2419 N Euclid Ave, Upland, CA 91784-1185 |
| Kiet T Bui | Optometry | 1931 N Campus Ave, Dr Kiet Bui Od, Upland, CA 91784-1667 | |
| James Cutler | Optometry | 1637 N Mountain Ave, Upland, CA 91784-1732 | |
| Fernando Moises Munguia | Oral Surgery | 1225 E 16th St, Suite 1, Upland, CA 91784-2402 | |
| Alfred S Garcia | Chiropractic | Upland Spine and Rehab | 1125 E 16th Street, Upland, CA 91784-9179 |
| City | UPLAND |
| Zip Code | 91784 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | UPLAND + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Samuel Salen.
| 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.