Western Imaging, Marina del Rey

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WESTERN IMAGING, MARINA DEL REY

Practice address

4640 Admiralty Way
Suite 102
Marina del Rey, CA 90292-6621

Phone

(310) 836-4700

Fax

(310) 836-6925

NPI assigned

Oct 4, 2006

Organization subpart

Yes

Parent organization

WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUPAs reported in NPPES

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

Authorized official

Name

Dr. Matthew J Lotysch, M.D.

Title

Medical Director

Phone

31083964700

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Western Imaging Center2 organizations share this tax ID, including this one

Part of

Western Imaging Center

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Western Imaging Center

  • Diagnostic Radiology Physician
  • Culver City, CA
  • NPI 1972696680
  NPD tax ID

Locations

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.

• Western Diagnostic & Therapeutic Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Marina del Rey, CA
  • NPI 1700979390
  NPPES parent name

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1528153665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9808 VENICE BLVD",
            "address_2": "2ND FLOOR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "90232",
            "telephone_number": "310-836-4700",
            "fax_number": "310-836-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 ADMIRALTY WAY",
            "address_2": "SUITE 102",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926621",
            "telephone_number": "310-836-4700",
            "fax_number": "310-836-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN IMAGING, MARINA DEL REY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUP",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "LOTYSCH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "31083964700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0017072",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Green Watkins III, M.D.
• Wesley Ryan MD PC
• Sandie West, LMT
• Western Diagnostic & Therapeutic Radiology Medical Group, Inc.
• Western Imaging Marina del Rey Inc
• Westside Therapy Services
• Emily Whalen, D.P.T.
• La Creasure White, NP-C
• Erin V Wigger, LMFT
• Gary Dewayne Wiley Jr., PA-C

• Diagnostic Radiology Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.