Organization
PEDIATRIC IMAGING MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD COHEN MD (PRESIDENT)
(510) 428-3410
Entity
Organization
Contact information
Practice address
747 52ND ST, OAKLAND, CA 94609-1809
(510) 428-3410
(510) 601-3968
Mailing address
PO BOX 6102, NOVATO, CA 94948-6102
(415) 884-3404
(415) 883-1836
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100504919
—
NV
05
—
GR0094540
—
CA
01
—
ZZZ09080Z
BLUE SHIELD OF CA
CA
Enumeration date
05/25/2006
Last updated
04/15/2015
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.
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