NPIMap

Organization Active NPI

La Jolla Radiology Medical Group - Diagnosis, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1689627317
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
LA JOLLA RADIOLOGY MEDICAL GROUP - DIAGNOSIS, INC.
Practice address
10150 Sorrento Valley Rd
Suite 320
San Diego, CA 92121-1635
Phone
(858) 454-4235
Fax
(858) 454-4644
NPI assigned
May 17, 2006
Last updated
Jun 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

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

Authorized official

Name
Peter H.B. McCreight, M.D.NPI 1083665236
Title
President
Phone
(858) 454-4235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

10150 Sorrento Valley Rd
Suite 320
San Diego, CA 92121-1635

Mailing address

P.O. Box 2570
Newbury Park, CA 91319-2570
Phone (800) 386-8024

Other identifiers 12

IdentifierTypeStateIssuer
GR0006796MedicaidCA
ZZZ00191ZOtherBLUE SHIELD
ZZZ00872ZOtherBLUE SHIELD
ZZZ71703ZOtherBLUE SHIELD
ZZZ23443ZOtherBLUE SHIELD
ZZZ777070ZOtherBLUE SHIELD
ZZZ00192ZOtherBLUE SHIELD
GR0006799MedicaidCA
ZZZ00873ZOtherBLUE SHIELD
ZZZ71703ZMedicaidCA
ZZZ73863ZOtherBLUE SHIELD
ZZZ73863ZMedicaidCA

National Provider Directory

National Provider Directory

Locations

955 Lane Ave
Ste 100
Chula Vista, CA 91914
Phone (619) 754-2259

332 Santa Fe Dr
Ste 105
Encinitas, CA 92024
Phone 7609436700772

345 Saxony Rd
Ste 106B
Encinitas, CA 92024
Phone (858) 454-4235

7301 Girard Ave
Ste B
La Jolla, CA 92037
Phone (858) 454-4235

9850 Genesee Ave
Ste 170B
La Jolla, CA 92037
Phone (858) 626-5225

Dept LA 21632
Pasadena, CA 91185

10150 Sorrento Valley Rd
Ste 320
San Diego, CA 92121
Phone (858) 454-4235

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1689627317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2570",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913192570",
            "telephone_number": "800-386-8024",
            "fax_number": "805-375-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SORRENTO VALLEY RD",
            "address_2": "SUITE 320",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211635",
            "telephone_number": "858-454-4235",
            "fax_number": "858-454-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA RADIOLOGY MEDICAL GROUP - DIAGNOSIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "MCCREIGHT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "H.B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-454-4235",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0006796",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ00191Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ00872Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ71703Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ23443Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ777070Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ00192Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0006799",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ00873Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ71703Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ73863Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ73863Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; 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.