Digital & Radiologic Imaging Associates Inc. a Medical Group

Organization Active NPI Diagnostic Radiology Physician · Fountain Valley, CA

NPI 1891747200 · NPPES record last updated Feb 27, 2008

Key facts

NPI
1891747200
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
Legal business name
DIGITAL & RADIOLOGIC IMAGING ASSOCIATES INC. A MEDICAL GROUP
Practice address
17100 Euclid St
Fountain Valley, CA 92708-4004
Phone
(714) 966-8041
NPI assigned
May 16, 2006
Organization subpart
No

Authorized official

Name
Elliott J. Wagner, M.D. NPI 1558312579
Title
President
Phone
(949) 348-1105

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 26

National Provider Directory

Locations

26401 Crown Valley Pkwy
#102
Mission Viejo, CA 92691
Phone (949) 348-1103

Dept LA 21780
Pasadena, CA 91185

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207U00000X
Diagnostic Radiology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2085R0202X Yes
Vascular & Interventional Radiology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2085R0204X

Addresses

Primary practice location

17100 Euclid St
Fountain Valley, CA 92708-4004

Mailing address

PO Box 3148
Mission Viejo, CA 92690-1148
Phone (949) 348-1105

Other identifiers

IdentifierTypeStateIssuer
ZZZ36724ZOtherCABLUE SHIELD
GR0019852MedicaidCA

Other providers in Fountain Valley, CA

All providers in Fountain Valley, CA · Diagnostic Radiology Physician in California

Sources for this page

Verify at the official NPI Registry.