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Organization
USC RADIOLOGY ASSOCIATES, INC
Active
Organization
USC RADIOLOGY ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD G GRANT M.D. (CHAIRMAN)
(626) 457-5842
Entity
Organization
Contact information
Practice address
1520 SAN PABLO ST, LOWER LEVEL , SUITE 1600, LOS ANGELES, CA 90033-5310
(323) 442-7450
(323) 442-7452
Mailing address
PO BOX 31399, LOS ANGELES, CA 90031-0399
(626) 457-5842
(626) 457-5843
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
NULL
2085B0100X
Body Imaging Physician
Primary
—
—
2085N0700X
Neuroradiology Physician
—
NULL
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
NULL
2085N0904X
Nuclear Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
NULL
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085R0205X
Radiological Physics Physician
—
NULL
2085R0205X
Radiological Physics Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
NULL
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0053630
—
CA
05
—
GR0053631
—
CA
05
—
GR0053632
—
CA
05
—
GR0053633
—
CA
05
—
GR0053634
—
CA
05
—
GR0053635
—
CA
01
—
ZZZ03313Z
BLUE SHIELD
CA
01
—
ZZZ08047Z
BLUE SHIELD
CA
01
—
ZZZ35208Z
BLUE SHIELD
CA
01
—
ZZZ35220Z
BLUE SHIELD
CA
Enumeration date
05/15/2006
Last updated
12/14/2007
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