| Organization Name: | ONLNE RADIOLOGY MEDICAL GROUP, INC. |
| NPI Number: | 1417353426 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAMUEL SALEN (M.D., CFO) |
| Mailing Address: | 315 Goldenrod Ave Corona Del Mar |
| State: | CA US |
| Postal Code: | 926252905 |
| Phone Number: | 9494809698 |
| Fax Number: | |
| NPI Enumeration Date: | 11/18/2014 |
| NPI Last Update Date: | 11/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | G57947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |