Healthcare Provider Details

I. General information

NPI: 1225542665
Provider Name (Legal Business Name): PEAK DIAGNOSTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 W 9TH AVE
ESCONDIDO CA
92025-5032
US

IV. Provider business mailing address

353 W 9TH AVE
ESCONDIDO CA
92025-5032
US

V. Phone/Fax

Practice location:
  • Phone: 619-752-0001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA137558
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberA137558
License Number StateCA

VIII. Authorized Official

Name: MICHAEL WANG
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 619-752-0001