Organization
GARDENA RADIOLOGY MEDICAL GROUP
Active
Parent organization
WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN DIAGNOSTIC & THERAPEUTIC RADIOLOGY MEDICAL GROUP
Authorized official
DR. JOHN N. LOIZEAUX-WITTE M.D. (CEO)
(310) 836-1574
Entity
Organization
Contact information
Practice address
1145 W REDONDO BEACH BLVD, GARDENA, CA 90247-3511
(310) 836-1574
Mailing address
PO BOX 17959, LOS ANGELES, CA 90017-0959
(213) 481-0584
(213) 481-0108
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0017071
—
CA
Enumeration date
09/05/2007
Last updated
04/24/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up