Magnolia Imaging Medical Group, Inc.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

C42348 Issued in CA

Legal business name

MAGNOLIA IMAGING MEDICAL GROUP, INC.

Practice address

17070 Colima Rd # G
Hacienda Heights, CA 91745-6781

Phone

(714) 891-2259

Fax

(714) 890-7030

NPI assigned

Aug 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thanh Phung, MDNPI 1952315319

Title

President

Phone

(714) 891-2259

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Thanh Gia Phung, M.D.

  • Diagnostic Radiology Physician
  • Tustin, CA
  • NPI 1952315319
  NPD (past) Authorized official
• Harris Newmark III, M.D.

  • Specialist
  • Pacific Palisades, CA
  • NPI 1730139148
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186704000000",
    "number": "1689866931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14571 MAGNOLIA ST STE 101",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926835575",
            "telephone_number": "714-891-2259",
            "fax_number": "714-890-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17070 COLIMA RD # G",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456781",
            "telephone_number": "714-891-2259",
            "fax_number": "714-890-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA IMAGING MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2007-08-10",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "THANH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-891-2259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C42348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Ma
• Erya Ma, L. AC.
• Allison Rivera Macabagdal, OTR/L
• Terry Macy
• Lauryn Isabella Magana
• Andrea C Mallet-Reece, MD
• Tatiana Celina Manriquez, B.A
• Fabrianne Martin
• Jose Martin, BCBA
• Monique Martinez

• Diagnostic Radiology Physician in Hacienda Heights, CA
• Providers in Hacienda Heights, 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 Aug 10, 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.