Organization
RENAISSANCE RADIOLOGY MEDICAL GROUP, INC
Active
Other names
Renaissance Radiology Medical Group, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONIKA KIEF GARCIA M.D. (CEO PRESIDENT)
(909) 620-8180
Entity
Organization
Contact information
Practice address
1760 W 16TH ST, SAN BERNARDINO, CA 92411-1160
(909) 620-8180
(909) 469-6741
Mailing address
1902 ROYALTY DR, SUITE 220, POMONA, CA 91767-3030
(909) 620-8180
(909) 469-6741
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG1263
RAILROAD MEDICARE
CA
05
—
GR0085397
—
CA
Enumeration date
07/21/2006
Last updated
06/24/2008
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