Provider Demographics
NPI:1851355622
Name:WASHINGTON RADIOLOGISTS MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:WASHINGTON RADIOLOGISTS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JYE-SHERN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-791-3411
Mailing Address - Street 1:PO BOX 5015
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-0915
Mailing Address - Country:US
Mailing Address - Phone:510-791-3411
Mailing Address - Fax:
Practice Address - Street 1:2000 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1716
Practice Address - Country:US
Practice Address - Phone:510-797-3342
Practice Address - Fax:510-713-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty