Organization Active NPI

Radiation Medical Group Inc

  • Specialist
  • San Diego, CA
National Provider Identifier
1912905308
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RADIATION MEDICAL GROUP INC
Practice address
2466 1St Ave
Ste B
San Diego, CA 92101-1408
Phone
(619) 230-0400
Fax
(858) 888-7757
NPI assigned
Jul 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Douglas G Myking, MBA
Title
Cfo/Executive Director
Phone
(858) 888-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2466 1St Ave
Ste B
San Diego, CA 92101-1408

Mailing address

PO Box 33865
San Diego, CA 92163-3865
Phone (858) 888-7700

Other identifiers 1

IdentifierTypeStateIssuer
GR0062070MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1912905308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33865",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921633865",
            "telephone_number": "858-888-7700",
            "fax_number": "858-888-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2466 1ST AVE",
            "address_2": "STE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011408",
            "telephone_number": "619-230-0400",
            "fax_number": "858-888-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIATION MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "MYKING",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "858-888-7700",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0062070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.