NPIMap

Organization Active NPI

Radiology Associates of San Luis Obispo

  • Radiology Clinic/Center
  • San Luis Obispo, CA
National Provider Identifier
1881661361
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO
Practice address
1064 Murray Ave
San Luis Obispo, CA 93405
Phone
(805) 543-5674
Fax
(805) 543-5818
NPI assigned
Mar 3, 2006
Organization subpart
Yes
Parent organization
RADIOLOGY ASSOCIATES OF SAN LUIS OBISPOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Dr. William M. Russell, MD
Title
Managing Partner
Phone
(805) 461-7080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1064 Murray Ave
San Luis Obispo, CA 93405

Mailing address

PO Box 2920
Atascadero, CA 93423-2920
Phone (805) 461-7080

Other identifiers 1

IdentifierTypeStateIssuer
GR0009773MedicaidCA

Other names 1

  • MRI of San Luis Obispo Doing business as

National Provider Directory

National Provider Directory
Part of
Radiology Associates of

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1881661361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2920",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934232920",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 MURRAY AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "93405",
            "telephone_number": "805-543-5674",
            "fax_number": "805-543-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RADIOLOGY ASSOCIATES OF SAN LUIS OBISPO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-461-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0009773",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRI of San Luis Obispo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.