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General NPI Number Information
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NPI Number | 1891741831
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Entity Type | Organization
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Legal Business Name | PHYSICIANS RADIOLOGY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 6386 ALVARADO CT 121
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City | SAN DIEGO
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State | CA
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Zip | 92120-4905
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Country | US
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Telephone | 619-229-6551
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Fax | 619-286-4524
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Provider Business Mailing Address
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Address Line | 8400 MIRAMAR RD 200
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City | SAN DIEGO
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State | CA
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Zip | 92126-4387
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Country | US
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Telephone | 858-564-1400
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Fax | 858-564-1500
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON ROBINS
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Credential | M.D.
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Telephone | 619-229-6551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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