| Organization Name: | QUEENS RADIOLOGY MEDICAL GROUP, INC. |
| NPI Number: | 1154427987 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN P LIN (CHAIRMAN) |
| Mailing Address: | 1300 N Vermont Ave Department Of Radiology Los Angeles |
| State: | CA US |
| Postal Code: | 900276005 |
| Phone Number: | 3239134860 |
| Fax Number: | 3239134922 |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |