NPIMap

Organization Active NPI

San Diego Diagnostic Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Poway, CA
National Provider Identifier
1144571076
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP, INC.
Practice address
15615 Pomerado Rd
Poway, CA 92064-2405
Phone
(858) 613-4000
NPI assigned
Oct 2, 2012
Last updated
Mar 22, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Authorized official

Name
Norman C. Chen, MDNPI 1700850815
Title
President/Ceo
Phone
(858) 565-0950

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary
Vascular & Interventional Radiology Physician 2085R0204X

Addresses

Primary practice location

15615 Pomerado Rd
Poway, CA 92064-2405

Mailing address

PO Box 23540
San Diego, CA 92193-3540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031112000793 CA Part B Supplier - Clinic/Group Practice 0143134353 Receives reassigned benefits from 72 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Diego, CA; Solana Beach, CA; Chula Vista, CA; Coronado, CA; Del Mar, CA; Encinitas, CA; La Jolla, CA; Laguna Niguel, CA…

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1144571076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23540",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921933540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15615 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642405",
            "telephone_number": "858-613-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "858-565-0950",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.