Organization Active NPI

Online Radiology Medical Group, Inc.

  • Diagnostic Radiology Physician
  • Irvine, CA
National Provider Identifier
1942607916
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A67523 Issued in CA
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, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.