NPIMap

Organization Active NPI

North Coast Imaging Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Wildomar, CA
National Provider Identifier
1245283217
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTH COAST IMAGING RADIOLOGY MEDICAL GROUP, INC.
Practice address
36485 Inland Valley Dr
Wildomar, CA 92595-9681
Phone
(951) 677-9713
Fax
(951) 677-9762
NPI assigned
May 18, 2006
Last updated
Jan 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Authorized official

Name
Jason Gary BeckNPI 1316150816
Title
Manager
Phone
(909) 347-9340

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

36485 Inland Valley Dr
Wildomar, CA 92595-9681

Mailing address

8605 Santa Monica Blvd
PMB 25192
West Hollywood, CA 90069-4109
Phone (800) 880-2973

Other practice location 1

25500 Medical Center Dr
Murrieta, CA 92562-5965
Phone (951) 696-6064

Other practice location 2

31700 Temecula Pkwy
Temecula, CA 92592-5896
Phone (951) 331-2260

Other identifiers 4

IdentifierTypeStateIssuer
GR0004490MedicaidCA
GR0004492MedicaidCA
ZZZ86398ZOtherBLUE SHIELD
ZZZ40340ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

25020 Las Brisas Rd
Ste 205D
Murrieta, CA 92562
Phone (951) 600-3811

25395 Hancock Ave
Ste 110
Murrieta, CA 92562
Phone (951) 696-4230

Dept LA 21693
Pasadena, CA 91185

1120 Sycamore Ave
Ste 2B
Vista, CA 92081
Phone (619) 598-7245

Practitioners & affiliated clinicians

Practitioners 12

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1245283217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8605 SANTA MONICA BLVD",
            "address_2": "PMB 25192",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900694109",
            "telephone_number": "800-880-2973",
            "fax_number": "951-600-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36485 INLAND VALLEY DR",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959681",
            "telephone_number": "951-677-9713",
            "fax_number": "951-677-9762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25500 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925625965",
            "country_code": "US",
            "telephone_number": "951-696-6064",
            "fax_number": "951-696-6193",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "31700 Temecula Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925925896",
            "country_code": "US",
            "telephone_number": "951-331-2260",
            "fax_number": "951-331-2261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTH COAST IMAGING RADIOLOGY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "909-347-9340"
    },
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0004490",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0004492",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ86398Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ40340Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.