Organization
RENAISSANCE RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIKA LYNNE KIEF-GARCIA M.D. (PRESIDENT, CEO)
(909) 620-8180
Entity
Organization
Contact information
Practice address
8599 HAVEN AVE., SUITE 300, RANCHO CUCAMONGA, CA 91730-4849
(909) 620-8180
(909) 919-7288
Mailing address
8599 HAVEN AVE., SUITE 300, RANCHO CUCAMONGA, CA 91730-4849
(909) 620-8180
(909) 919-7288
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
CA
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C08660
BUSINESS LICENSE
CA
05
—
GR0085392
—
CA
05
—
GR0085394
—
CA
05
—
GR008539B
—
CA
05
—
GR008539C
—
CA
05
—
GR008539F
—
CA
05
—
GR008539K
—
CA
Enumeration date
10/18/2006
Last updated
07/21/2011
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