Home Portable X-Ray

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

RHT3605 Issued in CA

Legal business name

HOME PORTABLE X-RAY

Practice address

30 So El Camino Real
Suite 109
San Mateo, CA 94401

Phone

(650) 347-1880

Fax

(650) 342-8379

NPI assigned

Dec 31, 2007

Last updated

Dec 31, 2007By 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

Mr. Charles WM Crouse, CRTNPI 1093846479

Title

Owner Operator

Phone

(650) 347-1880

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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.

• Charles William Crouse, CRT

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • San Mateo, CA
  • NPI 1093846479
  NPD (past) Authorized official

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1396920047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MAPLE ST",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94402",
            "telephone_number": "650-703-9701",
            "fax_number": "650-342-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 SO EL CAMINO REAL",
            "address_2": "SUITE 109",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94401",
            "telephone_number": "650-347-1880",
            "fax_number": "650-342-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME PORTABLE X-RAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "CROUSE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WM",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "650-347-1880",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRT"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "CA",
            "license": "RHT3605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ31682Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROV ID",
            "identifier": "ZZZ31682Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROV ID",
            "identifier": "ZZZ31682Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Holman
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• Miriam Home
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• Michelle Honaker
• Helen Hong, DMD
• Hoyman Hong, M.D.

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.