Healthcare Provider Details

I. General information

NPI: 1124414123
Provider Name (Legal Business Name): NEW HOPE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 E ALVARADO ST D
FALLBROOK CA
92028-2350
US

IV. Provider business mailing address

18065 VENTURA BLVD
ENCINO CA
91316-3517
US

V. Phone/Fax

Practice location:
  • Phone: 768-689-6100
  • Fax: 760-689-6110
Mailing address:
  • Phone: 818-708-6163
  • Fax: 818-344-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0207X
TaxonomyMobile Mammography Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberMD17100
License Number StateOR

VIII. Authorized Official

Name: JRFFREY DOUGLAS LOVIN
Title or Position: RADIOLOGIST
Credential: M.D.
Phone: 858-442-0535