Tustin Teleradiology Medical Group Inc.

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

License

G74535 Issued in CA

Legal business name

TUSTIN TELERADIOLOGY MEDICAL GROUP INC.

Practice address

13422 Newport Ave
Suite I
Tustin, CA 92780-3746

Phone

(714) 665-6900

Fax

(714) 665-6904

NPI assigned

Jun 4, 2006

Last updated

Jan 1, 2019By 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

Dr. Thomas L Atlas, MDNPI 1346288321

Title

Owner

Phone

(714) 665-6900

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 4

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.

• Thomas L Atlas, MD

  • Radiography Radiologic Technologist
  • Tustin, CA
  • NPI 1346288321
  Authorized official Same address or phone
• Kuldeep S Gill, M.D.

  • Pulmonary Disease Physician
  • Fresno, CA
  • NPI 1184623969
  NPD (past)
• Siu-Ming Tam, M.D.

  • Diagnostic Radiology Physician
  • Tustin, CA
  • NPI 1578657292
  NPD (past)
• Bella G Zey, MD

  • Cardiovascular Disease Physician
  • Studio City, CA
  • NPI 1881894129
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546300800000",
    "number": "1326086703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE",
            "address_2": "SUITE I",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-665-6900",
            "fax_number": "714-665-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13422 NEWPORT AVE",
            "address_2": "SUITE I",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803746",
            "telephone_number": "714-665-6900",
            "fax_number": "714-665-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUSTIN TELERADIOLOGY MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2019-01-01",
        "status": "A",
        "authorized_official_last_name": "ATLAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-665-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "CA",
            "license": "G74535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "ZZZ57939Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G745350",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002082232",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiography Radiologic Technologist in Tustin, CA
• Providers in Tustin, CA by specialty
• Radiography Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2019; 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.