Radiology Associates of San Luis Obispo

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO

Practice address

1310 Las Tablas Rd
Ste 103
Templeton, CA 93465-9737

Phone

(805) 434-0829

Fax

(805) 434-0826

NPI assigned

Feb 15, 2006

Organization subpart

Yes

Parent organization

RADIOLOGY ASSOCIATES OF SAN LUIS OBISPOAs reported in NPPES

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

Authorized official

Name

Dr. William M. Russell, MD

Title

Managing Partner

Phone

(805) 461-7080

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Radiology Diagnostic Center Doing business as

Part of

Radiology Associates of

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Radiology Associates of San Luis Obispo

  • Diagnostic Radiology Physician
  • Atascadero, CA
  • NPI 1063612570
  NPPES parent name

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1366416307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2920",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934232920",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 LAS TABLAS RD",
            "address_2": "STE 103",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659737",
            "telephone_number": "805-434-0829",
            "fax_number": "805-434-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-461-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0009775",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiology Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathryn Pozzi, NP-C
• Prier Medical Clinic a Professional Corporation
• Richard Charles Prier, M.D.
• Adele M Prior
• Kelly Pywtorak, RDN
• Radiology Associates of San Luis Obispo, a Medical Group Inc
• Jennefer Radojevic, L.AC., MSTOM
• Kaila Rall, CWC II
• Randolph S Lawrence MD a Medical Corp
• Karim Rasheed, M.D.

• Radiology Clinic/Center in Templeton, CA
• Providers in Templeton, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.