NPIMap

Organization Active NPI

Stat Radiology Medical Corporation

Doing business as Same

  • Diagnostic Radiology Physician
  • Poway, CA
National Provider Identifier
1720322894
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
STAT RADIOLOGY MEDICAL CORPORATION
Doing business as
Same
Practice address
13915 Danielson St
Suite 200
Poway, CA 92064-8884
Phone
(858) 546-3800
Fax
(858) 546-3900
NPI assigned
Nov 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Manal M. Schoellerman, M.D.NPI 1821060724
Title
Practice Administrator
Phone
(858) 546-3800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

13915 Danielson St
Suite 200
Poway, CA 92064-8884

Mailing address

13915 Danielson St
Suite 200
Poway, CA 92064-8884
Phone (858) 546-3800

Other names 1

  • Same Doing business as

National Provider Directory

National Provider Directory

Locations

13915 Danielson St
Ste 200
Poway, CA 92064
Phone (858) 835-3723

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1720322894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13915 DANIELSON ST",
            "address_2": "SUITE 200",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920648884",
            "telephone_number": "858-546-3800",
            "fax_number": "858-546-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13915 DANIELSON ST",
            "address_2": "SUITE 200",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920648884",
            "telephone_number": "858-546-3800",
            "fax_number": "858-546-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT RADIOLOGY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "SCHOELLERMAN",
        "authorized_official_first_name": "MANAL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "858-546-3800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Same",
            "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 Nov 15, 2012; 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.