NPIMap

Organization Active NPI

West Coast Radiology Center - Anaheim

  • Radiology Clinic/Center
  • Anaheim, CA
National Provider Identifier
1053541128
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
WEST COAST RADIOLOGY CENTER - ANAHEIM
Practice address
1085 N Harbor Blvd
Anaheim, CA 92801-2417
Phone
(714) 300-0703
Fax
(714) 300-0704
NPI assigned
Jul 22, 2009
Last updated
Jul 28, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST COAST RADIOLOGY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael L. Black, M.D.NPI 1780620955
Title
President
Phone
(714) 835-6055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1085 N Harbor Blvd
Anaheim, CA 92801-2417

Mailing address

1085 N Harbor Blvd
Anaheim, CA 92801-2417
Phone (714) 300-0703

Other identifiers 1

IdentifierTypeStateIssuer
W10646OtherMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
West Coast Breast Center-Santa Ana4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1053541128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 N HARBOR BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012417",
            "telephone_number": "714-300-0703",
            "fax_number": "714-300-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 N HARBOR BLVD",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012417",
            "telephone_number": "714-300-0703",
            "fax_number": "714-300-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST RADIOLOGY CENTER - ANAHEIM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST COAST RADIOLOGY, INC.",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-835-6055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W10646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.