Organization Active NPI

Imaging Healthcare Specialists Medical Group, Inc.

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1750498093
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
IMAGING HEALTHCARE SPECIALISTS MEDICAL GROUP, INC.
Practice address
6256 Greenwich Dr
Suite 150
San Diego, CA 92122-5941
Phone
(866) 558-4320
Fax
(619) 294-8399
NPI assigned
Aug 24, 2006
Last updated
Oct 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

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

Authorized official

Name
Thomas D Cleary
Title
President & Ceo
Phone
(866) 558-4320

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X NU
Diagnostic Radiology Physician 2085R0202X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU

Addresses

Primary practice location

6256 Greenwich Dr
Suite 150
San Diego, CA 92122-5941

Mailing address

File 1317 1801 W Olympic Blvd
Pasadena, CA 91199-1317
Phone (888) 927-8018

Other identifiers 14

IdentifierTypeStateIssuer
GR0103682MedicaidCA
GR0103686MedicaidCA
GR0103680MedicaidCA
GR0103683MedicaidCA
GR0103687MedicaidCA
GR0103688MedicaidCA
GR010368AMedicaidCA
GR010368CMedicaidCA
GR0103689MedicaidCA
GR0103685MedicaidCA
GR010368BMedicaidCA
GR0103681MedicaidCA
GR0103684MedicaidCA
GR010368DMedicaidCA

National Provider Directory

National Provider Directory

Locations

333 H St
Ste 1095
Chula Vista, CA 91910
Phone (619) 409-9119

855 Third Ave
Ste 1110
Chula Vista, CA 91911
Phone (619) 409-9119

317 14th St
Del Mar, CA 92014
Phone (858) 481-6717

477 N El Camino Real
Ste A102
Encinitas, CA 92024
Phone (760) 452-7150

25405 Hancock Ave
Ste 107
Murrieta, CA 92562
Phone (909) 600-4848

1801 W Olympic Blvd
#1317
Pasadena, CA 91199

3366 5th Ave
San Diego, CA 92103
Phone (619) 230-0400

4033 3rd Ave
Ste 100
San Diego, CA 92103
Phone (619) 229-2299

6256 Greenwich Dr
Ste 150
San Diego, CA 92122
Phone (866) 558-4320

6386 Alvarado Ct
Ste 107
San Diego, CA 92120
Phone (619) 229-2299

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1750498093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 1317 1801 W OLYMPIC BLVD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911991317",
            "telephone_number": "888-927-8018",
            "fax_number": "800-508-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6256 GREENWICH DR",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921225941",
            "telephone_number": "866-558-4320",
            "fax_number": "619-294-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGING HEALTHCARE SPECIALISTS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "CLEARY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "866-558-4320"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103682",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103686",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103680",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103683",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103687",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103688",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR010368A",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR010368C",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103689",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103685",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR010368B",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103681",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103684",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR010368D",
            "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 Oct 29, 2013; 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.