Organization
SANTA ANA TUSTIN RADIOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GEOFFERY STEIN M.D. (PRESIDENT)
(714) 835-3709
Entity
Organization
Contact information
Practice address
1450 N TUSTIN AVE, SUITE 132, SANTA ANA, CA 92705-8640
(714) 835-3709
(714) 836-7034
Mailing address
1450 N TUSTIN AVE, SUITE 132, SANTA ANA, CA 92705-8640
(714) 835-3709
(714) 836-7034
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
FNP 27532
CA
2085N0700X
Neuroradiology Physician
FNP 27532
CA
2085N0904X
Nuclear Radiology Physician
FNP 27532
CA
2085R0202X
Diagnostic Radiology Physician
Primary
FNP 27532
CA
2085R0204X
Vascular & Interventional Radiology Physician
FNP 27532
CA
2085U0001X
Diagnostic Ultrasound Physician
FNP 27532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0011440
—
CA
Enumeration date
06/29/2006
Last updated
09/20/2007
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