Organization
ST JUDE RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE NICOLE DAVISON (ADMINISTRATIVE ASSISTANT)
(714) 992-3200
Entity
Organization
Contact information
Practice address
101 E VALENCIA MESA DR, FULLERTON, CA 92835
(714) 992-3000
(714) 992-3928
Mailing address
101 E VALENCIA MESA DR, FULLERTON, CA 92835-3809
(714) 992-3000
(714) 992-3928
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ49329Z
—
CA
Enumeration date
11/06/2006
Last updated
08/04/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us