Healthcare Provider Details

I. General information

NPI: 1649596792
Provider Name (Legal Business Name): OMNIRAD MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2010
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16400 LARK AVE STE 125
LOS GATOS CA
95032-2547
US

IV. Provider business mailing address

PO BOX 8237
PASADENA CA
91109-8237
US

V. Phone/Fax

Practice location:
  • Phone: 408-403-5996
  • Fax: 408-371-0462
Mailing address:
  • Phone: 408-371-0390
  • Fax: 408-371-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANUP K SINGH
Title or Position: CEO
Credential: M.D.
Phone: 408-371-0390