EISENHOWER RADIOLOGY MEDICAL GROUP, INC – NPI #1124079868
Radiology

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

EISENHOWER RADIOLOGY MEDICAL GROUP, INC is a radiologist located in RANCHO MIRAGE, CA. NPPES has assigned the NPI number 1124079868 to EISENHOWER RADIOLOGY MEDICAL GROUP, INC on May 15, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “EISENHOWER RADIOLOGY MEDICAL GROUP, INC” is a dba name, the actual legal business name for this organization is PALM DESERT RADIOLOGY MEDICAL GROUP, INC. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

The NPI profile was previously updated about 2 years ago on Feb 05, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EISENHOWER RADIOLOGY MEDICAL GROUP, INC below.

NPI Profile for
PALM DESERT RADIOLOGY MEDICAL GROUP, INC

NPI Number
1124079868
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PALM DESERT RADIOLOGY MEDICAL GROUP, INC
Doing Business As (dba): EISENHOWER RADIOLOGY MEDICAL GROUP, INC
Website
Primary location
39000 BOB HOPE DR
RANCHO MIRAGE, CA 92270
Phone: (760) 837-8449 Fax: (775) 624-9774
Mailing address
PO BOX 1629
EVANSVILLE, IN 47706-0030
Phone: (760) 837-8449 Fax: (760) 773-1848
Organization Subpart
No
Authorized Official
MEHRAN ELLY
PRESIDENT
Phone: (760) 837-8449
Updated
Certification Date
Feb 05, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EISENHOWER RADIOLOGY MEDICAL GROUP, INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherBLUE SHIELD OF CACAZZZ40340Z
otherRR MEDICARECACC9030
medicaidCA1124079868
medicaidCAGR0012730
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.