Basic Information
| Provider Information | |||||||||
| NPI: | 1124414123 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW HOPE HEALTHCARE LLC | ||||||||
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| OtherOrganizationName: | HOPE IMAGING MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18065 VENTURA BLVD | ||||||||
| Address2: | |||||||||
| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913163517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187086163 | ||||||||
| FaxNumber: | 8183441390 | ||||||||
| Practice Location | |||||||||
| Address1: | 616 E ALVARADO ST | ||||||||
| Address2: | D | ||||||||
| City: | FALLBROOK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920282350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7686896100 | ||||||||
| FaxNumber: | 7606896110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2015 | ||||||||
| LastUpdateDate: | 08/07/2015 | ||||||||
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| AuthorizedOfficialLastName: | LOVIN | ||||||||
| AuthorizedOfficialFirstName: | JRFFREY | ||||||||
| AuthorizedOfficialMiddleName: | DOUGLAS | ||||||||
| AuthorizedOfficialTitleorPosition: | RADIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 8584420535 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0207X | N | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile Mammography | 261QR0200X | MD17100 | OR | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.