Provider Demographics
NPI:1801906268
Name:HILLCREST MRI MEDICAL GROUP
Entity type:Organization
Organization Name:HILLCREST MRI MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHIH
Authorized Official - Last Name:CHIU
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:805-375-7999
Mailing Address - Street 1:1001 NEWBURY RD
Mailing Address - Street 2:#100 HILLCREST MRI MEDICAL GROUP
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-6434
Mailing Address - Country:US
Mailing Address - Phone:805-375-7925
Mailing Address - Fax:805-375-7977
Practice Address - Street 1:1001 NEWBURY RD
Practice Address - Street 2:#100 HILLCREST MRI MEDICAL GROUP MEDICAL IMAGING MEDICA
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6434
Practice Address - Country:US
Practice Address - Phone:805-375-7925
Practice Address - Fax:805-375-7977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG789522085R0202X, 2085U0001X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA34702Medicare UPIN
WC31784FMedicare PIN
CAW11774Medicare ID - Type Unspecified
W11774Medicare PIN