Organization
ST VINCENT RADIOLOGICAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
E. MICHAEL MCMONIGLE M.D. (PRESIDENT)
(213) 484-7901
Entity
Organization
Contact information
Practice address
201 S ALVARADO ST, SUITE 311, LOS ANGELES, CA 90057-2320
(213) 413-6771
Mailing address
PO BOX 19130, NEWBURY PARK, CA 91319-9130
(213) 484-7901
(213) 353-0325
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ80786Z
BLUE SHIELD
CA
05
—
ZZZ80786Z
—
CA
Enumeration date
05/19/2006
Last updated
08/26/2008
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