Active NPI
Online Radiology Medical Group, Inc.
- Diagnostic Radiology Physician
- Irvine, CA
National Provider Identifier
1942607916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A67523
- Legal business name
- ONLINE RADIOLOGY MEDICAL GROUP, INC.
- Practice address
- 115 Coral Rose
Irvine, CA 92603-0177 - Phone
- (949) 280-8420
- NPI assigned
- Nov 19, 2014
- Last updated
- Nov 19, 2014
- 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
- Samuel Salen
- Title
- M.D., Cfo
- Phone
- (951) 786-0801
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A67523 | CA | Primary |
Addresses
Primary practice location
115 Coral Rose
Irvine, CA 92603-0177
Mailing address
75 Remittance Dr
Dept. 6620
Chicago, IL 60675-6620
Phone (888) 412-2639
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1416355200000",
"number": "1942607916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 REMITTANCE DR",
"address_2": "DEPT. 6620",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606756620",
"telephone_number": "888-412-2639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 CORAL ROSE",
"city": "IRVINE",
"state": "CA",
"postal_code": "926030177",
"telephone_number": "949-280-8420"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ONLINE RADIOLOGY MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A",
"authorized_official_last_name": "SALEN",
"authorized_official_first_name": "SAMUEL",
"authorized_official_title_or_position": "M.D., CFO",
"authorized_official_telephone_number": "951-786-0801"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A67523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.