Redwood Radiology Imaging Medical Clinic

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G72357 Issued in CA

Legal business name

REDWOOD RADIOLOGY IMAGING MEDICAL CLINIC

Practice address

3300 Renner Dr
Fortuna, CA 95540-3120

Phone

(707) 725-3361

NPI assigned

Sep 1, 2006

Last updated

Aug 22, 2020By 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

Dr. Stephen Lindsay Viltrakis, M DNPI 1992891295

Title

Vice President

Phone

(707) 768-1988

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Stephen Lindsay Viltrakis, M D

  • Diagnostic Radiology Physician
  • Fortuna, CA
  • NPI 1992891295
  NPD (past) Authorized official
• Gary Hungerford Baker, M D

  • Diagnostic Radiology Physician
  • Fortuna, CA
  • NPI 1275635278
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598867426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6640",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955026640",
            "telephone_number": "707-768-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 RENNER DR",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403120",
            "telephone_number": "707-725-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWOOD RADIOLOGY IMAGING MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VILTRAKIS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "LINDSAY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "707-768-1988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G72357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0079730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Pirouz, PA-C
• Red Phoenix Recovery LLC (Red Phoenix Recovery)
• Redwood Internal Medicine (Huppenbauer & Rangel MD)
• Redwood Memorial Hospital
• Redwood Pediatric Medical Group
• Redwood Women's Center, a Medical Corporation
• Redwood Women's Health Center
• Redwoods Rural Health Center, Inc. (Redwoods Rural Health Center -Fortuna)
• Reflective Practices Therapeutic Services (Reflective Practices)
• Remi Vista, Inc.

• Diagnostic Radiology Physician in Fortuna, CA
• Providers in Fortuna, 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 22, 2020; 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.