Central Medical Group

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CENTRAL MEDICAL GROUP

Practice address

710 S Central Ave Ste 310
Glendale, CA 91204-4641

Phone

(747) 215-6350

Fax

(747) 215-6242

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas N Dzebolo Jr., M.D.NPI 1932239837

Title

Mdical Director

Phone

(747) 215-6350

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicholas N Dzebolo, MD

  • Interventional Cardiology Physician
  • Sacramento, CA
  • NPI 1932239837

  Nuclear Cardiology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1639924319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 310",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044641",
            "telephone_number": "747-215-6350",
            "fax_number": "747-215-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S CENTRAL AVE STE 310",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044641",
            "telephone_number": "747-215-6350",
            "fax_number": "747-215-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "DZEBOLO",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MDICAL DIRECTOR",
        "authorized_official_telephone_number": "747-215-6350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Hearing Centers, Inc.
• Central Home Health Agency
• Central Home Health Care Inc.
• Central Hospice, Inc.
• Central Medical Business Management
• Central Medical Hospice, Inc.
• Central Neuro Diagnostic, Inc
• Central Pharmacy Group Inc
• Central Pharmacy Group Inc
• Central Surgery Center LLC

• Diagnostic Radiology Physician in Glendale, CA
• Providers in Glendale, 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 Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.