NPIMap

Organization Active NPI

Golden Gate Radiology Medical Group, Inc

  • Diagnostic Radiology Physician
  • Daly City, CA
National Provider Identifier
1427409986
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
GOLDEN GATE RADIOLOGY MEDICAL GROUP, INC
Practice address
386 Gellert Blvd
Daly City, CA 94015-2611
Phone
(415) 677-2320
Fax
(415) 677-2444
NPI assigned
Jun 27, 2016
Last updated
Jun 27, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Authorized official

Name
Dr. Roger Eng, M.D.NPI 1871607291
Title
Authorized Official
Phone
(559) 455-4109

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

386 Gellert Blvd
Daly City, CA 94015-2611

Mailing address

PO Box 26750
Fresno, CA 93729-6750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000364 CA Part B Supplier - Clinic/Group Practice 4880792779 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Francisco, CA; Daly City, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1427409986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26750",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 GELLERT BLVD",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152611",
            "telephone_number": "415-677-2320",
            "fax_number": "415-677-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN GATE RADIOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "ENG",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "559-455-4109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.