St Marys Radiology Medical Group

LBN: St Marys Radiology Medical Group
St Marys Radiology Medical Group is an health care organization with primary practice located at 1045 Atlantic Ave Suite 105, Long Beach CA 90813-3408. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. St Marys Radiology Medical Group can be contacted via phone (562) 437-3833, or through Vanley, Gregory T via phone (562) 437-3833.

Contact Information

Primary practice address
1045 Atlantic Ave Suite 105 Long Beach CA 90813-3408
Phone: (562) 437-3833
Fax: (562) 624-0741
Website:
Map and Directions
Authorized official contact:
Name: Vanley, Gregory T Doctor of Medicine (MD)
Phone: (562) 437-3833

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1043258676
LBN Legal business name St Marys Radiology Medical Group
DBA Doing business as
Authorized official Vanley, Gregory T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 4th, 2006
Last updated Apr 9th, 2014 - about 10 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 1043258676 NPPES
California MEDICAID GR0003580

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