Organization
NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.
Active
Parent organization
NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.
Other names
Tustin Imaging Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEWPORT CENTER RADIOLOGY MEDICAL GROUP INC.
Authorized official
MICHAEL C ROOSSIN MD (PRESIDENT)
(949) 263-8620
Entity
Organization
Contact information
Practice address
15000 KENSINGTON PARK DR, TUSTIN, CA 92782-1830
(714) 477-8340
(714) 477-8341
Mailing address
DEPT LA 21705, PASADENA, CA 91185-1705
(949) 263-8620
(714) 727-1007
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
11/26/2018
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