Healthcare Provider Details

I. General information

NPI: 1023051620
Provider Name (Legal Business Name): NORTH STATE RADIOLOGY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 COHASSET RD SUITE # 150
CHICO CA
95926-2241
US

IV. Provider business mailing address

1720 ESPLANADE
CHICO CA
95926-3315
US

V. Phone/Fax

Practice location:
  • Phone: 530-898-0504
  • Fax: 530-345-4505
Mailing address:
  • Phone: 530-898-0504
  • Fax: 530-898-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: GARY A STROMBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 530-898-0504