COMMUNITY MOBILE ULTRASOUND, LLC
Complete NPI Record 1760620959
Radiology - Diagnostic Ultrasound in Oceanside, CA
Active since January 27, 2009
Complete NPI Dataset
This page contains the complete raw NPPES record for Community Mobile Ultrasound, Llc (NPI 1760620959), a radiology organization in Oceanside, CA. All 38 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1760620959 Field 1/38
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/38
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/38
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: COMMUNITY MOBILE ULTRASOUND, LLC Field 4/38
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: Not available Field 5/38
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 6 Field 6/38
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 215 SCHILLING CIR STE 114 Field 7/38
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: HUNT VALLEY Field 8/38
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MD Field 9/38
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 210311113 Field 10/38
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/38
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 8007868015 Field 12/38
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 2141 S EL CAMINO REAL STE A&B Field 13/38
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: OCEANSIDE Field 14/38
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: CA Field 15/38
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 920549003 Field 16/38
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/38
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5102789030 Field 18/38
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 4438427264 Field 19/38
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: CUOMO Field 22/38
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: BRIAN Field 23/38
- The first name of the authorized official.
- Authorized Official Middle Name: C Field 24/38
- The middle name of the authorized official.
- Authorized Official Title or Position: AUTHORIZED OFFICIAL/CFO Field 25/38
- The title or position of the authorized official.
- Authorized Official Telephone Number: 8007868015 Field 26/38
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 2085U0001X Field 27/38
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 28/38
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: P01099709 Field 29/38
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 30/38
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: CA Field 31/38
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: RRMC Field 32/38
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 2: 1760620959 Field 33/38
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 01 Field 34/38
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier Issuer 2: NPI Field 35/38
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: N Field 36/38
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 37/38
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Other Organization Names 1
Additional business and trade names this provider has on file with the NPPES registry.
TridentCare Doing Business As
Name 1/1Doing Business As: A trade name or operating name under which an organization provides services, distinct from its registered legal business name.
Secondary Practice Locations 16
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
70 E Sunrise Hwy Ste 500
Location 1/16Valley Stream, NY 11581-1233 · Phone (800) 786-8015 · Fax (443) 842-7264
2550 Corporate Exchange Dr Ste 15
Location 2/16Columbus, OH 43231-1660 · Phone (800) 786-8015 · Fax (443) 842-7264
3418 Midcourt Rd Ste 105
Location 3/16Carrollton, TX 75006-4944 · Phone (800) 786-8015 · Fax (443) 842-7264
2116 Dabney Rd Ste A1
Location 4/16Richmond, VA 23230-3341 · Phone (800) 786-8015
1134 Industry Dr
Location 5/16Tukwila, WA 98188-4803 · Phone (800) 786-8015 · Fax (443) 842-7264
2901A Parnell Ave
Location 6/16Fort Wayne, IN 46805-2548 · Phone (800) 786-8015 · Fax (443) 842-7264
10948 Bigge St
Location 7/16San Leandro, CA 94577-1121 · Phone (510) 300-8170 · Fax (443) 842-7264
7776 S Pointe Pkwy W Ste 150
Location 8/16Phoenix, AZ 85044-5427 · Phone (800) 786-8015
7355 Prairie Falcon Rd
Location 9/16Las Vegas, NV 89128-0801 · Phone (800) 786-8015 · Fax (443) 842-7264
2505 Lord Baltimore Dr Ste E
Location 10/16Baltimore, MD 21244-2673 · Phone (800) 786-8015 · Fax (443) 842-7264
9110 Leesgate Rd Ste 6
Location 11/16Louisville, KY 40222-5053 · Phone (800) 786-8015
7700 Brush Hill Rd
Location 12/16Burr Ridge, IL 60527-7544 · Phone (630) 521-1010 · Fax (602) 343-5856
95-202 Halepio Pl
Location 13/16Mililani, HI 96789-5552 · Phone (800) 786-8015 · Fax (443) 842-7264
1001 Virginia Ave Ste 302
Location 14/16Hapeville, GA 30354-1367 · Phone (800) 786-8015 · Fax (443) 842-7264
2502 E University Dr Ste 290
Location 15/16Phoenix, AZ 85034-6932 · Phone (800) 786-8015 · Fax (443) 842-7264
4400 140th Ave N Ste 200-230
Location 16/16Clearwater, FL 33762-3832 · Phone (800) 786-8015 · Fax (443) 842-7264
Other Provider Identifiers 2
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
P01099709 Other
Identifier 1/2State: CA · Issuer: Rrmc
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
1760620959 Other
Identifier 2/2Issuer: Npi
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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