Renaissance Radiology Medical Group, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RENAISSANCE RADIOLOGY MEDICAL GROUP, INC

Practice address

2224 Medical Center Dr
Perris, CA 92571-2638

Phone

(909) 570-3108

NPI assigned

Jul 10, 2007

Last updated

Oct 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Linda S. Kaufman

Title

Billing Manager

Phone

(909) 570-3108

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1144428350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 ROYALTY DR",
            "address_2": "SUITE 220",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673030",
            "telephone_number": "909-570-3108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 MEDICAL CENTER DR",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925712638",
            "telephone_number": "909-570-3108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE RADIOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "909-570-3108"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ05740Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilian Wagas Reed
• German Regin
• Bianca Reid, MPH, CHES
• Sounisra Reid
• Tameka Reid
• J Regan Renaud
• Alma Resendiz
• Reuben C Castillo, Professional Corporation
• Rosa M Reyes
• Shaylie Mackenzie Reyes

• Diagnostic Radiology Physician in Perris, CA
• Providers in Perris, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; 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.