Medical Diagnostic Digital Center , Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

RHT70625 Issued in CA

Legal business name

MEDICAL DIAGNOSTIC DIGITAL CENTER , INC.

Practice address

722 Nina LN
Foster City, CA 94404-1721

Phone

(415) 370-9605

Fax

(650) 341-5838

NPI assigned

May 6, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Mark Neyzberg, X-RAY TECH

Title

President

Phone

(415) 370-9605

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 05X0009995

Legal name

MEDICAL DIAGNOSTIC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

Nov 23, 1996

Last certification

Aug 25, 2016

Ownership / control type

Corporation

Facility address

722 Nina Lane (RHB 35842)
Foster City, CA 94404

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael J. Faer, M.D.

  • Radiation Oncology Physician
  • Oakland, CA
  • NPI 1932192242
  NPD
• Michael Maiman, MD

  • Diagnostic Radiology Physician
  • Oakland, CA
  • NPI 1588659882
  NPD

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1073747911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 NINA LN",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041721",
            "telephone_number": "415-370-9605",
            "fax_number": "650-341-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NINA LN",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041721",
            "telephone_number": "415-370-9605",
            "fax_number": "650-341-5838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DIAGNOSTIC DIGITAL CENTER , INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "NEYZBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-370-9605",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "X-RAY TECH"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "RHT70625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XR009995F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clifton Matsuno, PT
• Maxim Healthcare Services, Inc.
• Robert Maxwell
• Sharol McGrogan, R.P.T.
• Patrick Mehdi McKinnie
• Catherine Goeke Meister, DMD
• Hongcheng Mi
• Michael Keiichi Fujinaka MD a Medical Corporation (Apex Pain and Wellness)
• Michelle S. Tam, M.D., Inc
• Stephen Allen Mikulic, DDS

• Clinical Medical Laboratory in Foster City, CA
• Providers in Foster City, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.