Medical Ultrasound Diagnostic Alliance Inc.

Primary specialty

Cardiovascular Specialist/TechnologistTaxonomy code 246X00000X

License

TG031 Issued in CA

Legal business name

MEDICAL ULTRASOUND DIAGNOSTIC ALLIANCE INC.

Practice address

20422 Leap Court
Walnut, CA 91789-3551

Phone

(626) 255-8383

Fax

(909) 595-7233

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Pak Chiu Peter Wong, RDCS

Title

President

Phone

(626) 255-8383

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114061280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20422 LEAP CT",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893551",
            "telephone_number": "626-255-8383",
            "fax_number": "909-595-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20422 LEAP COURT",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917893551",
            "telephone_number": "626-255-8383",
            "fax_number": "909-595-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ULTRASOUND DIAGNOSTIC ALLIANCE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "PAK CHIU",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-255-8383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RDCS"
    },
    "taxonomies": [
        {
            "code": "246X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist Cardiovascular",
            "state": "CA",
            "license": "TG031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDTF PROVIDER #",
            "identifier": "TG031",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cardiovascular Specialist/Technologist in Walnut, CA
• Providers in Walnut, CA by specialty
• Cardiovascular Specialist/Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.