Healthcare Provider Details

I. General information

NPI: 1205897568
Provider Name (Legal Business Name): VALLEY RADIOLOGY CONSULTANTS MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 N ELM ST SUITE 102
ESCONDIDO CA
92025-3431
US

IV. Provider business mailing address

PO BOX 1671
EVANSVILLE IN
47706-0072
US

V. Phone/Fax

Practice location:
  • Phone: 760-739-5400
  • Fax: 760-739-8440
Mailing address:
  • Phone: 760-520-8500
  • Fax: 760-520-8523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number153360
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number153360
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number153360
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number153360
License Number StateCA

VIII. Authorized Official

Name: DR. ALLEN B. NALBANDIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-520-8500