NPIMap

Organization Active NPI

Advanced Memorial Imaging Group, a Medical Corporation

  • Diagnostic Radiology Physician
  • Fullerton, CA
National Provider Identifier
1902008642
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ADVANCED MEMORIAL IMAGING GROUP, A MEDICAL CORPORATION
Practice address
301 W Bastanchury Rd
#130
Fullerton, CA 92835-3419
Phone
(714) 278-9363
Fax
(714) 278-9364
NPI assigned
Jun 4, 2007
Last updated
Aug 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Authorized official

Name
Jagdish M. Patel, MDNPI 1497739593
Title
President
Phone
(714) 278-9363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X

Addresses

Primary practice location

301 W Bastanchury Rd
#130
Fullerton, CA 92835-3419

Mailing address

17868 US Highway 18
#358
Apple Valley, CA 92307-1267
Phone (760) 946-5177

National Provider Directory

National Provider Directory

Locations

301 W Bastanchury Rd
Ste 130
Fullerton, CA 92835
Phone (714) 278-9363

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377129600000",
    "number": "1902008642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17868 US HIGHWAY 18",
            "address_2": "#358",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071267",
            "telephone_number": "760-946-5177",
            "fax_number": "760-946-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "#130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-278-9363",
            "fax_number": "714-278-9364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEMORIAL IMAGING GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "JAGDISH",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-278-9363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.