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ST JUDE RADIOLOGY MEDICAL GROUP INC
NPI 1649349705
Radiology - Diagnostic Radiology in Fullerton, CA

Active since November 06, 2006
101 E VALENCIA MESA DR, FULLERTON, CA 92835(714) 992-3000(714) 992-3928 Get Directions Write a Review

NPPES record last updated: August 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 4, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About St Jude Radiology Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ST JUDE RADIOLOGY MEDICAL GROUP INC (NPI 1649349705) is a healthcare organization registered as a diagnostic radiology in Fullerton, California and active in the NPI registry since November 2006. The organization lists Renee Nicole Davison, Administrative Assistant, as its authorized official.

NPPES Registry Identity

NPI1649349705
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameST JUDE RADIOLOGY MEDICAL GROUP INC
Location Address101 E VALENCIA MESA DRFullerton, CA 92835
Mailing Address101 E Valencia Mesa DrFullerton, CA 92835-3809 · (714) 992-3000 · Fax (714) 992-3928
Phone(714) 992-3000
Fax(714) 992-3928
Organization SubpartNo
Authorized OfficialRenee Nicole DavisonAdministrative Assistant · (714) 992-3200
Enumeration DateNovember 6, 2006
Last NPPES UpdateAugust 4, 20252 updates tracked since enumeration
NPPES CertifiedAugust 4, 2025
✔ NPI 1649349705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
101 E VALENCIA MESA DR, Fullerton, CA 92835
Open in Google Maps ↗

Other Identifiers 1

MedicaidZZZ49329ZCA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PIUS J. KIM M.D.
Internal Medicine
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 447-5027
PARAM WALIA MD NEUROSCIENCES SERVICES CORPORATION
Neurological Surgery
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 446-5830
JOHN BYRON MACCARTHY MD
Anesthesiology
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 871-3280
GLORIA LYNN FRANKLIN NP MSN
Nurse Practitioner (Family)
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (909) 717-9589
DR. MARTIN JOSEPH BREEN JR. PHARM.D.
Pharmacist (Pharmacotherapy)
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 992-3143
NELSON IVAN AGUINAGA RN, FNP
Nurse Practitioner (Family)
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 871-3280
DR. JONATHON AHN MD
Anesthesiology
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 871-3280
MR. DANIEL BENJAMIN GRAVILONI RCP
Respiratory Therapist, Registered (Neonatal/Pediatrics)
101 E VALENCIA MESA DR
FULLERTON, CA 92835
Orange County (714) 992-3000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St Jude Radiology Medical Group Inc's NPI number?

The NPI number for St Jude Radiology Medical Group Inc is 1649349705. It was assigned to this organization in the NPPES registry on November 6, 2006.

Where is St Jude Radiology Medical Group Inc located?

St Jude Radiology Medical Group Inc is located at 101 E Valencia Mesa Dr, Fullerton, CA 92835. The listed phone number is (714) 992-3000.

What is St Jude Radiology Medical Group Inc's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for St Jude Radiology Medical Group Inc was last updated on August 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.