Provider Demographics
NPI:1548265036
Name:TRUXTUN RADIOLOGY MEDICAL GROUP, L.P.
Entity type:Organization
Organization Name:TRUXTUN RADIOLOGY MEDICAL GROUP, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GIRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-325-6800
Mailing Address - Street 1:1817 TRUXTUN AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5008
Mailing Address - Country:US
Mailing Address - Phone:661-325-6800
Mailing Address - Fax:661-325-2409
Practice Address - Street 1:1817 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5008
Practice Address - Country:US
Practice Address - Phone:661-325-6800
Practice Address - Fax:661-325-2409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 24510261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT40257GOtherMEDI-CAL GOOD SAM UR/CARE
CAZZZ32102ZOtherBLUE SHIELD PROVIDER NO
CAGR0052534Medicaid
CAHSC30257GOtherMEDI-CAL GOOD SAM IN/PT
CAHSP40724FOtherMEDI-CAL BHH OUT/PT
CACH1686OtherMEDICARE RAILROAD
CAGR0047433Medicaid
CAGR0052530Medicaid
CAHSP30724FOtherMEDI-CAL BHH IN/EMG PT
CAGR0052451Medicaid
CAZZZ17197ZOtherBLUE SHIELD PROVIDER NO
CAHSP30724FOtherMEDI-CAL BHH IN/EMG PT
CAZZZ15408ZMedicare PIN
CAZZZ22336ZMedicare PIN
CAZZZ22337ZMedicare PIN
CAGR0052451Medicaid
CAZZZ25213ZMedicare PIN
CAZZZ25346ZMedicare PIN