Organization · Type 2 NPI

Uc Regents

Diagnostic Radiology Physician · Fountain Valley, CA

NPI number 1902177785 Active

Practice location

11190 Warner Ave, Suite 110
Fountain Valley, CA 92708-4019

Call (714) 456-5676 Map

Fax (714) 456-6216

Mailing address

1500 S Douglass Rd, Suite 200, Rt 183
Anaheim, CA 92806-6911

Specialties and licenses

Taxonomy	Code	License
Diagnostic Radiology Physician Primary	2085R0202X	None listed

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

35 other providers at this address

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NPI record

NPI: 1902177785
Entity type: Organization (Type 2)
Issued: Jan 25, 2012
Last updated: May 21, 2024
Status: Active
Subpart: Yes of Uc Regents

Other names

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Uci Health-Fountain Valley Imaging-Warner Ave · doing business as
Uci Health-Fountain Valley Imaging-Warner · doing business as

Authorized official

Randolph Perseverance Siwabessy
Vice President and Chief Financial
(714) 456-5180

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1902177785

Uc Regents's National Provider Identifier is 1902177785, issued on Jan 25, 2012. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Fountain Valley, CA. The record was last updated on May 21, 2024.