Organization
IMAGING HEALTHCARE SPECIALISTS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS D CLEARY (PRESIDENT & CEO)
(866) 558-4320
Entity
Organization
Contact information
Practice address
6256 GREENWICH DR, SUITE 150, SAN DIEGO, CA 92122-5941
(866) 558-4320
(619) 294-8399
Mailing address
FILE 1317 1801 W OLYMPIC BLVD, PASADENA, CA 91199-1317
(888) 927-8018
(800) 508-4751
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0103680
—
CA
05
—
GR0103681
—
CA
05
—
GR0103682
—
CA
05
—
GR0103683
—
CA
05
—
GR0103684
—
CA
05
—
GR0103685
—
CA
05
—
GR0103686
—
CA
05
—
GR0103687
—
CA
05
—
GR0103688
—
CA
05
—
GR0103689
—
CA
05
—
GR010368A
—
CA
05
—
GR010368B
—
CA
05
—
GR010368C
—
CA
05
—
GR010368D
—
CA
Enumeration date
08/24/2006
Last updated
10/29/2013
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