Active NPI
Radiation Medical Group Inc
- Specialist
- San Diego, CA
National Provider Identifier
1912905308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0062070 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI 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
- Radiant Hearts Home Care LLC
- Radiant Mind Neuro and Psychology Clinic Inc
- Radiant Speech Therapy, Inc.
- Radiation Medical Group
- Radiation Medical Group Inc
- Paloma Radice
- Radiological Associates Medical Group, Inc
- Radiological Associates Medical Group, Inc
- Radiology Medical Group Inc
- Radiology Professional Solutions, PC
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.