Organization
PHYSICIANS RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON ROBINS M.D. (PRESIDENT)
(619) 229-6551
Entity
Organization
Contact information
Practice address
6386 ALVARADO CT, 121, SAN DIEGO, CA 92120-4905
(619) 229-6551
(619) 286-4524
Mailing address
8400 MIRAMAR RD, 200, SAN DIEGO, CA 92126-4387
(858) 564-1400
(858) 564-1500
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ35437Z
BLUE SHIELD
—
01
—
ZZZ35440Z
BLUE SHIELD
—
05
—
ZZZ80191Z
—
CA
05
—
ZZZ80428Z
—
CA
Enumeration date
05/25/2006
Last updated
11/27/2007
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