Stockdale Radiology Physicians Services, Inc.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A113992 Issued in CA

Legal business name

STOCKDALE RADIOLOGY PHYSICIANS SERVICES, INC.

Practice address

3411 Bayview Dr
Manhattan Beach, CA 90266-3332

Phone

(559) 455-4109

Fax

(916) 533-0313

NPI assigned

Apr 7, 2017

Organization subpart

No

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

Authorized official

Name

David G. Suadi, D.O.

Title

President

Phone

(559) 455-9109

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Stockdale Radiology Physician Services, Inc

  • Diagnostic Radiology Physician
  • San Francisco, CA
  • NPI 1487108403

  O20140429000939

  Same enrollment
• Stockdale Radiology Physician Services, Inc

  • Diagnostic Radiology Physician
  • Ventura, CA
  • NPI 1710339833

  O20140429000939

  Same enrollment
• Stockdale Radiology Physicians Services, Inc

  • Diagnostic Radiology Physician
  • Bakersfield, CA
  • NPI 1669806402

  O20140429000939

  Same enrollment

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1760915607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 EMPIRE DR STE 100",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933090401",
            "telephone_number": "661-631-8000",
            "fax_number": "661-631-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 BAYVIEW DR",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663332",
            "telephone_number": "559-455-4109",
            "fax_number": "916-533-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKDALE RADIOLOGY PHYSICIANS SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "SUADI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-455-9109",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A113992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ellen Starobin, R.N., M.S., GNP
• Howard E Stein, OD
• Jonathan Mark Stein, O.D.
• Jennifer Lynne Stever, D.O.
• Stillwater Group Inc
• Sarah Stoker, PHD
• Suchir Sheth Podiatry Corporation
• Sun Valley Medical Devices Inc.
• Surfside Surgery Center, LLC
• Surgery Center of Manhattan Beach LLC

• Diagnostic Radiology Physician in Manhattan Beach, CA
• Providers in Manhattan Beach, 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 Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.