Organization
SAINT JOHN'S TOWER IMAGING MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD M ROTH M.D. (PRESIDENT)
(323) 549-3030
Entity
Organization
Contact information
Practice address
1328 22ND ST, DEPARTMENT OF RADIOLOGY, SANTA MONICA, CA 90404-2032
(310) 829-8814
(310) 315-6192
Mailing address
DEPT LA 21568, PASADENA, CA 91185-1568
(888) 727-1073
(866) 752-2240
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059370
—
CA
01
—
ZZZ39865Z
BLUE SHIELD OF CA
CA
Enumeration date
05/24/2006
Last updated
04/02/2009
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