Active NPI
Charles F Glover, M.D
- Diagnostic Radiology Physician
- Hemet, CA
National Provider Identifier
1144254624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G12861
- Practice address
- Hemet Radiology Medical Group, Inc.
235 Laursen Street
Hemet, CA 92543 - Phone
- (951) 765-5417
- Fax
- (951) 765-5418
- NPI assigned
- Jul 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G12861 | CA | Primary |
Addresses
Primary practice location
Hemet Radiology Medical Group, Inc.
235 Laursen Street
Hemet, CA 92543
Mailing address
PO Box 2497
Fallbrook, CA 92088-2497
Phone (790) 728-3202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G128610 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G12861 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hemet Radiology Medical Group, Inc. | Diagnostic Radiology | Past | Accepting new patients |
| Apex Radiology Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Hemet, CA
- NPI 1750650982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144254624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2497",
"city": "FALLBROOK",
"state": "CA",
"postal_code": "920882497",
"telephone_number": "790-728-3202",
"fax_number": "760-728-1901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HEMET RADIOLOGY MEDICAL GROUP, INC.",
"address_2": "235 LAURSEN STREET",
"city": "HEMET",
"state": "CA",
"postal_code": "92543",
"telephone_number": "951-765-5417",
"fax_number": "951-765-5418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "CHARLES",
"middle_name": "F",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G12861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G128610",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.