St Jude Radiology Medical Group Inc

LBN: St Jude Radiology Medical Group Inc
St Jude Radiology Medical Group Inc is an health care organization with primary practice located at 101 East Valencia Mesa Drive , Fullerton CA 92835. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as the primary health care specialty. St Jude Radiology Medical Group Inc can be contacted via phone (714) 992-3978, or through Morten, Robert Clive via phone (714) 992-3978.

Contact Information

Primary practice address
101 East Valencia Mesa Drive Fullerton CA 92835
Phone: (714) 992-3978
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Morten, Robert Clive Doctor of Medicine (MD)
Phone: (714) 992-3978

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X

Profile Details

NPI number 1649349705
LBN Legal business name St Jude Radiology Medical Group Inc
DBA Doing business as
Authorized official Morten, Robert Clive Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649349705 NPPES
California MEDICAID ZZZ49329Z

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