Orange Coast Radiology Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

A31455 Issued in CA

Legal business name

ORANGE COAST RADIOLOGY MEDICAL GROUP INC

Practice address

1081 N China Lake Blvd
Ridgecrest, CA 93555-3130

Phone

(760) 446-0642

NPI assigned

Sep 19, 2006

Organization subpart

No

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

Authorized official

Name

Michael Shangian, MD

Title

President

Phone

(714) 754-5804

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414540800000",
    "number": "1790882231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73878",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926730130",
            "telephone_number": "949-206-6800",
            "fax_number": "949-206-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 N CHINA LAKE BLVD",
            "city": "RIDGECREST",
            "state": "CA",
            "postal_code": "935553130",
            "telephone_number": "760-446-0642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COAST RADIOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-19",
        "last_updated": "2014-10-29",
        "status": "A",
        "authorized_official_last_name": "SHANGIAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-754-5804",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A31455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A314550",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ74221Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Ridgecrest, CA
• Providers in Ridgecrest, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; 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.