Active NPI
Conrado Olalia Quemuel, CRT
- Radiography Radiologic Technologist
- Tustin, CA
National Provider Identifier
1568968899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiography Radiologic Technologist
- License
- RHF00097408
- Practice address
- 242 Preble Dr
Tustin, CA 92780-3720 - Phone
- (714) 474-1149
- NPI assigned
- Apr 4, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | RHF00097408 | CA | Primary |
Addresses
Primary practice location
242 Preble Dr
Tustin, CA 92780-3720
Mailing address
17282 Amaganset Way
Tustin, CA 92780-2506
Phone (714) 474-1149
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHF00097408 | Other | CA | STATE OF CALIFORNIA RADIOLOGIC TECHNOLOGIST LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RHF00097408 | CA | MD | Radiography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727481600000",
"number": "1568968899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17282 AMAGANSET WAY",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927802506",
"telephone_number": "714-474-1149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 PREBLE DR",
"city": "TUSTIN",
"state": "CA",
"postal_code": "927803720",
"telephone_number": "714-474-1149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEMUEL",
"first_name": "CONRADO",
"middle_name": "OLALIA",
"name_prefix": "Mr.",
"credential": "CRT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-04",
"last_updated": "2024-09-28",
"certification_date": "2024-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "CA",
"license": "RHF00097408",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF CALIFORNIA RADIOLOGIC TECHNOLOGIST LICENSE",
"identifier": "RHF00097408",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tustin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.