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Organization
SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP, INC.
Active
Organization
SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD W PADELFORD (EXECUTIVE VICE PRESIDENT)
(858) 565-0950
Entity
Organization
Contact information
Practice address
765 MEDICAL CENTER CT, SAN DIEGO IMAGING - CHULA VISTA, CHULA VISTA, CA 91911-6600
(619) 397-6577
(619) 397-5182
Mailing address
PO BOX 23540, SAN DIEGO, CA 92193-3540
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083811
—
CA
Enumeration date
06/28/2006
Last updated
03/22/2017
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