NPIMap

Organization Active NPI

San Gabriel Vip, a California Limited Partnership

Doing business as Valley Imaging Partnership

  • Diagnostic Radiology Physician
  • West Covina, CA
National Provider Identifier
1619908480
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SAN GABRIEL VIP, A CALIFORNIA LIMITED PARTNERSHIP
Doing business as
Valley Imaging Partnership
Practice address
1401 W Merced Ave
Suite 102
West Covina, CA 91790-3401
Phone
(626) 813-9988
Fax
(626) 813-0075
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Dr. Donald D. Kasierman, M.D.
Title
Medical Director
Phone
(626) 813-9988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1401 W Merced Ave
Suite 102
West Covina, CA 91790-3401

Mailing address

PO Box 635
West Covina, CA 91793-0635
Phone (626) 813-9988

Other identifiers 1

IdentifierTypeStateIssuer
GR0058272MedicaidCA

Other names 1

  • Valley Imaging Partnership Doing business as

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1619908480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917930635",
            "telephone_number": "626-813-9988",
            "fax_number": "626-813-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W MERCED AVE",
            "address_2": "SUITE 102",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903401",
            "telephone_number": "626-813-9988",
            "fax_number": "626-813-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL VIP, A CALIFORNIA LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "KASIERMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "626-813-9988",
        "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": "GR0058272",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Imaging Partnership",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.