Provider Demographics
NPI:1205897568
Name:VALLEY RADIOLOGY CONSULTANTS MEDICAL GROUP, INC
Entity type:Organization
Organization Name:VALLEY RADIOLOGY CONSULTANTS MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NALBANDIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-520-8500
Mailing Address - Street 1:PO BOX 1671
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47706-0072
Mailing Address - Country:US
Mailing Address - Phone:760-520-8500
Mailing Address - Fax:760-520-8523
Practice Address - Street 1:255 N ELM ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3431
Practice Address - Country:US
Practice Address - Phone:760-739-5400
Practice Address - Fax:760-739-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2085R0202X
CA1533602085R0204X, 208600000X, 2086S0129X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0017531Medicaid
CAGR0017534Medicaid
CAZZZ79403ZMedicaid
CAGR0017532Medicaid
CAGR0017530Medicaid
CAGR0017535Medicaid
CG3625Medicare PIN
CAGR0017534Medicaid
CAGR0017531Medicaid
CAZZZ79403ZMedicaid
CAW1538IMedicare PIN
CAW1538EMedicare PIN
CAW1538HMedicare PIN
CAW1538CMedicare PIN
CAW1538Medicare PIN
CAGR0017532Medicaid
CAGR0017535Medicaid
CAW1538GMedicare PIN