Provider Demographics
NPI:1639163991
Name:NEWHOPE IMAGING CENTER LLC
Entity Type:Organization
Organization Name:NEWHOPE IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WILLENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-431-0303
Mailing Address - Street 1:PO BOX 9089
Mailing Address - Street 2:NEWHOPE IMAGING CENTER
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92728-9089
Mailing Address - Country:US
Mailing Address - Phone:714-431-0303
Mailing Address - Fax:714-431-0393
Practice Address - Street 1:17815 NEWHOPE ST
Practice Address - Street 2:SUITE S
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5426
Practice Address - Country:US
Practice Address - Phone:714-431-0303
Practice Address - Fax:714-431-0393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X98379Medicare UPIN
TP115Medicare ID - Type Unspecified
TP115Medicare PIN