National Provider Identifier Database

SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Contact Information

SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
250 PROSPECT PL
SHARP CORONADO HOSPITAL
CORONADO, CA  92118-1943
Phone: 619-522-3721
Fax: 619-522-3780
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X
Body Imaging 2085B0100X
Diagnostic Ultrasound 2085U0001X
Interventional Pain Medicine 208VP0014X
Neuroradiology 2085N0700X
Nuclear Cardiology 207UN0901X
Nuclear Imaging & Therapy 207UN0902X
Nuclear Medicine 207U00000X
Nuclear Radiology 2085N0904X
Pain Medicine 208VP0000X
Pediatric Radiology 2085P0229X
Radiation Oncology 2085R0001X
Radiation Oncology 2085R0203X
Vascular & Interventional Radiology 2085R0204X

* Indicates primary specialty

NPI Profile & details for SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC

NPI Number 1417988221
Legal business name
LBN		 SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Authorized official NORMAN CHEN - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 07/06/2006
Last updated 04/21/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: B1982005164
  • CA Medicaid: GR0083813

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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