San Luis Imaging Medical Group, Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

FNP27421 Issued in CA

Legal business name

SAN LUIS IMAGING MEDICAL GROUP, INC

Practice address

1100 Monterey St # 200
San Luis Obispo, CA 93401-3102

Phone

(972) 730-6700

Fax

(805) 542-0584

NPI assigned

May 22, 2014

Last updated

May 26, 2026By 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. Fred S Vernacchia, M.D.

Title

President

Phone

(972) 730-6700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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.

• Eric Jason Gray, M.D.

  • Diagnostic Radiology Physician
  • Stanford, CA
  • NPI 1417489626
  Medicare reassignment Care Compare group NPD
• Andy Hoang, MD

  • Diagnostic Radiology Physician
  • San Luis Obispo, CA
  • NPI 1235658485
  Medicare reassignment Care Compare group NPD
• Elizabeth Michelle Vogler, MD

  • Diagnostic Radiology Physician
  • Templeton, CA
  • NPI 1023004173
  Medicare reassignment Care Compare group NPD
• Kristen Wikholm Kieley, M.D.

  • Diagnostic Radiology Physician
  • San Luis Obispo, CA
  • NPI 1780810606
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779753600000",
    "number": "1649682840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST # 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "972-730-6700",
            "fax_number": "805-542-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 MONTEREY ST # 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013102",
            "telephone_number": "972-730-6700",
            "fax_number": "805-542-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS IMAGING MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A",
        "authorized_official_last_name": "VERNACCHIA",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-730-6700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "FNP27421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Luis Chronic Pain Massage Therapy
• San Luis Coastal Unified School District
• San Luis Dermatology, Inc.
• San Luis Diagnostic Medical Associates
• San Luis Hospitalists a Medical Corporation
• San Luis Internal Medicine Associates, a Medical Corporation
• San Luis Obispo
• San Luis Obispo Behavioral Health
• San Luis Obispo Behavioral Health
• San Luis Obispo Ca Endoscopy ASC LP (Endoscopy Center of the Central Coast)

• Diagnostic Radiology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 May 26, 2026; 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.