NPIMap

Organization Active NPI

Clinical Diagnostic Radiology in Nuclear Medicine

  • Diagnostic Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1245399401
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CLINICAL DIAGNOSTIC RADIOLOGY IN NUCLEAR MEDICINE
Practice address
7600 N 15TH St Ste 102
Phoenix, AZ 85020-4330
Phone
(805) 577-2167
NPI assigned
Dec 6, 2006
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
David Cohen
Title
President Managing Member
Phone
(818) 879-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

7600 N 15TH St Ste 102
Phoenix, AZ 85020-4330

Mailing address

PO Box 53300
Phoenix, AZ 85072-3300

Other identifiers 2

IdentifierTypeStateIssuer
474031MedicaidAZ
AZ0047590OtherBCBSAZ

National Provider Directory

National Provider Directory

Locations

10575 N Tatum Blvd
Ste C126
Paradise Vly, AZ 85253
Phone (480) 998-1490

2222 E Highland Ave
Ste 120
Phoenix, AZ 85016
Phone (602) 977-1177

7600 N 15th St
Ste 300
Phoenix, AZ 85020
Phone (602) 331-1771

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1245399401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53300",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850723300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST STE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204330",
            "telephone_number": "805-577-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL DIAGNOSTIC RADIOLOGY IN NUCLEAR MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT MANAGING MEMBER",
        "authorized_official_telephone_number": "818-879-9600"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "474031",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0047590",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.