Organization
SAN DIEGO DIAGNOSTIC RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN C. CHEN MD (PRESIDENT CEO)
(858) 565-0950
Entity
Organization
Contact information
Practice address
3020 CHILDRENS WAY, CHILDREN'S HOSPITAL AND HEALTH CENTER, SAN DIEGO, CA 92123-4223
(858) 966-7769
(858) 966-8568
Mailing address
PO BOX 23540, SAN DIEGO, CA 92193-3540
(858) 565-0950
(858) 244-1100
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
B1982005164
CA
207UN0901X
Nuclear Cardiology Physician
B1982005164
CA
207UN0902X
Nuclear Imaging & Therapy Physician
B1982005164
CA
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0001X
Radiation Oncology Physician
B1982005164
CA
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0203X
Therapeutic Radiology Physician
B1982005164
CA
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
208VP0000X
Pain Medicine Physician
B1982005164
CA
208VP0014X
Interventional Pain Medicine Physician
B1982005164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0083810
—
CA
Enumeration date
07/06/2006
Last updated
03/23/2017
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