# USC RADIOLOGY ASSOCIATES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225089865
- **Authorized official:** DR. EDWARD G GRANT M.D. (CHAIRMAN)
- **Authorized official phone:** (626) 457-5842

## Contact information

- **Practice address:** 1520 SAN PABLO ST, LOWER LEVEL , SUITE 1600, LOS ANGELES, CA 90033-5310
- **Practice address phone:** (323) 442-7450
- **Practice address fax:** (323) 442-7452
- **Mailing address:** PO BOX 31399, LOS ANGELES, CA 90031-0399
- **Mailing address phone:** (626) 457-5842
- **Mailing address fax:** (626) 457-5843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | — | NULL | Yes |
| 2085B0100X | Body Imaging Physician | — | — | Yes |
| 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

- **Enumeration date:** 05/15/2006
- **Last updated:** 12/14/2007

## 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 |