San Gabriel Valley Diagnostic Center Medical Group
LBN: San Gabriel Valley Diagnostic Center Medical Group
San Gabriel Valley Diagnostic Center Medical Group is an health care organization with primary practice located at 1509 W Cameron Ave Suite D, West Covina CA 91790-2725. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty.
San Gabriel Valley Diagnostic Center Medical Group can be contacted via phone (626) 962-3525, or through Krishnasamy, Bharath Kumar via phone (626) 962-3525.
Contact Information
Primary practice address
1509 W Cameron Ave Suite D
West Covina CA 91790-2725
Phone: (626) 962-3525
Fax: (626) 962-0032
Website:
Authorized official contact:
Name: Krishnasamy, Bharath Kumar Doctor of Medicine (MD)
Phone: (626) 962-3525
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ||
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X |
Profile Details
| NPI number | 1790725141 |
|---|---|
| LBN Legal business name | San Gabriel Valley Diagnostic Center Medical Group |
| DBA Doing business as | |
| Authorized official | Krishnasamy, Bharath Kumar Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 7th, 2006 |
| Last updated | May 25th, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790725141 | NPPES |
| California | Other | ZZZ11986Z | BLUE SHIELD OF CALIF |
| California | MEDICAID | GR0023300 | BLUE SHIELD OF CALIF |
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