NPIMap

Organization Active NPI

Iemisi

Doing business as Iemisi Dept of Radiology

  • Diagnostic Radiology Physician
  • Corona, CA
National Provider Identifier
1639843592
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IEMISI
Doing business as
Iemisi Dept of Radiology
Practice address
1902 Fullerton Ave # 1
Corona, CA 92881
Phone
(951) 479-8994
Fax
(619) 209-7888
NPI assigned
Aug 4, 2021
Last updated
Aug 4, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
IEMISIAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2021

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

Authorized official

Name
Michael Sedrak, MDNPI 1750464111
Title
Director
Phone
(951) 479-8994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

1902 Fullerton Ave # 1
Corona, CA 92881

Mailing address

1902 Fullerton Ave # 1
Corona, CA 92881-3112
Phone (951) 479-8994

Other names 1

  • IEMISI DEPT OF RADIOLOGY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Iemisi2 organizations share this tax ID, including this one
Part of
Iemisi

Other organizations with this tax ID 1

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

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1628035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1639843592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 FULLERTON AVE # 1",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813112",
            "telephone_number": "951-479-8994",
            "fax_number": "619-209-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 FULLERTON AVE # 1",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92881",
            "telephone_number": "951-479-8994",
            "fax_number": "619-209-7888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IEMISI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IEMISI",
        "enumeration_date": "2021-08-04",
        "last_updated": "2021-08-04",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "SEDRAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-479-8994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IEMISI DEPT OF RADIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.