Active NPI
Russell N Low, MD
- Diagnostic Radiology Physician
- San Diego, CA
National Provider Identifier
1497729446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- G58511
- Practice address
- 8745 Aero Drive
Suite 200
San Diego, CA 92123-1774 - Phone
- (858) 565-0950
- Fax
- (858) 244-1100
- NPI assigned
- Feb 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | G58511 | CA | Primary |
| Body Imaging Physician | 2085B0100X | G58511 | CA | |
| Diagnostic Ultrasound Physician | 2085U0001X | G58511 | CA | |
| Neuroradiology Physician | 2085N0700X | G58511 | CA | |
| Nuclear Radiology Physician | 2085N0904X | G58511 | CA | |
| Pediatric Radiology Physician | 2085P0229X | G58511 | CA |
Addresses
Primary practice location
8745 Aero Drive
Suite 200
San Diego, CA 92123-1774
Mailing address
PO Box 23540
San Diego, CA 92193-3540
Phone (858) 565-0950
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ75341Z | Medicaid | CA | |
| GR0083810 | Medicaid | CA | |
| GR0083811 | Medicaid | CA | |
| GR0083813 | Medicaid | CA | |
| GR0083816 | Medicaid | CA | |
| GR0083812 | Medicaid | CA | |
| GR0083815 | Medicaid | CA | |
| GR0083814 | Medicaid | CA | |
| GR0083817 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G58511 | CA | MD | Diagnostic Ultrasound Physician |
| 58511 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Diagnostic Radiology Medical Group, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Magnetic Resonance Imaging (MRI) Clinic/Center
- San Diego, CA
- NPI 1861788093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1497729446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23540",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921933540",
"telephone_number": "858-565-0950",
"fax_number": "858-244-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8745 AERO DRIVE",
"address_2": "SUITE 200",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921231774",
"telephone_number": "858-565-0950",
"fax_number": "858-244-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOW",
"first_name": "RUSSELL",
"middle_name": "N",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-15",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "G58511",
"primary": true
},
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "CA",
"license": "G58511",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "CA",
"license": "G58511",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "CA",
"license": "G58511",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "CA",
"license": "G58511",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "CA",
"license": "G58511",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZZ75341Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083810",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083811",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083813",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083816",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083812",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083815",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083814",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0083817",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.