NPIMap

Organization Active NPI

Fully Open MRI of Rancho Bernardo LLC Dba Pomerado Imaging

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Poway, CA
National Provider Identifier
1689635971
Registry record updated Dec 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
License
3184 Issued in CA
Legal business name
FULLY OPEN MRI OF RANCHO BERNARDO LLC DBA POMERADO IMAGING
Practice address
15725 Pomerado Rd
Suite 109
Poway, CA 92064-2068
Phone
(858) 485-6094
Fax
(858) 485-6059
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2007

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

Authorized official

Name
Dr. Andrew D Polansky, M.D.
Title
Managing Member
Phone
(760) 520-8500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X 3184 CA Primary
Radiology Clinic/Center 261QR0200X 3184 CA

Addresses

Primary practice location

15725 Pomerado Rd
Suite 109
Poway, CA 92064-2068

Mailing address

PO Box 460875
Escondido, CA 92046-0875
Phone (760) 520-8500

Other names 1

  • Pomerado Imaging Doing business as

National Provider Directory

National Provider Directory

Locations

15725 Pomerado Rd
Ste 109
Poway, CA 92064
Phone (858) 485-6094

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198022400000",
    "number": "1689635971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460875",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920460875",
            "telephone_number": "760-520-8500",
            "fax_number": "760-520-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD",
            "address_2": "SUITE 109",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642068",
            "telephone_number": "858-485-6094",
            "fax_number": "858-485-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLY OPEN MRI OF RANCHO BERNARDO LLC DBA POMERADO IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-12-19",
        "status": "A",
        "authorized_official_last_name": "POLANSKY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "760-520-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "CA",
            "license": "3184",
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "3184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pomerado Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.