Healthcare Provider Details

I. General information

NPI: 1710963418
Provider Name (Legal Business Name): RAD-IMAGE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE LONG BEACH MEMORIAL MEDICAL CENTER
LONG BEACH CA
90806-1737
US

IV. Provider business mailing address

100 OCEANGATE STE 1000
LONG BEACH CA
90802-4312
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-2000
  • Fax:
Mailing address:
  • Phone: 562-590-7400
  • Fax: 562-590-7452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JAGDISH M PATEL
Title or Position: PRESIDENT
Credential: MD
Phone: 562-590-7400