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General NPI Number Information
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NPI Number | 1609802842
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Entity Type | Organization
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Legal Business Name | WEST RAD MEDICAL GROUP
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 1100-A N TUSTIN AVE
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City | SANTA ANA
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State | CA
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Zip | 92705-3509
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Country | US
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Telephone | 714-835-6055
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Fax | 714-835-3287
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Provider Business Mailing Address
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Address Line | PO BOX 11924
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City | SANTA ANA
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State | CA
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Zip | 92711-1924
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Country | US
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Telephone | 714-835-3709
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Fax | 714-836-7034
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK GEOFFERY STEIN
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Credential | M.D.
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Telephone | 714-835-6055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number | 042713
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 042713
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number | 042713
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 042713
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 042713
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 042713
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License Number State | CA
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