NPIMap

Organization Active NPI

Los Angeles Radiology Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Glendale, CA
National Provider Identifier
1366525487
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LOS ANGELES RADIOLOGY MEDICAL ASSOCIATES, INC.
Practice address
1509 Wilson Terrace
Glendale, CA 91206-4007
Phone
(818) 409-8000
Fax
(414) 607-3946
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Linh L. Chen, MDNPI 1922182385
Title
Owner
Phone
(818) 434-8489

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0904X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Therapeutic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0203X
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

1509 Wilson Terrace
Glendale, CA 91206-4007

Mailing address

PO Box 509015
Dept 296
San Diego, CA 92150-9015
Phone (614) 210-1885

Other identifiers 1

IdentifierTypeStateIssuer
GR0104040MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, GA, HI, PA, NY5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20070124000506 CA Part B Supplier - Clinic/Group Practice 7517968167 Receives reassigned benefits from 53 practitioners
Practice locations: Corona del Mar, CA; Yorba Linda, CA; Santa Ana, CA; Sacramento, CA; Paradise, CA; Los Angeles, CA; Hermosa Beach, CA; Glendale, CA…
O20130725000257 GA Part B Supplier - Clinic/Group Practice 7517968167 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, GA; Tybee Island, GA; Rome, GA
O20201014001384 HI Part B Supplier - Clinic/Group Practice 7517968167 Receives reassigned benefits from 2 practitioners
Practice locations: Honolulu, HI
O20201210001606 PA Part B Supplier - Clinic/Group Practice 7517968167 Receives reassigned benefits from 1 practitioner
Practice locations: Presto, PA
O20201229002665 NY Part B Supplier - Clinic/Group Practice 7517968167 Receives reassigned benefits from 2 practitioners
Practice locations: Brooklyn, NY; Schenectady, NY

National Provider Directory

National Provider Directory

Locations

48677 Victoria Ln
Oakhurst, CA 93644
Phone (559) 683-2711

Practitioners & affiliated clinicians

Practitioners 54

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1366525487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509015",
            "address_2": "DEPT 296",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921509015",
            "telephone_number": "614-210-1885",
            "fax_number": "614-210-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TERRACE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "414-607-3946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES RADIOLOGY MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "LINH",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-434-8489",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0104040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.