California Imaging Network Medical Group

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

CALIFORNIA IMAGING NETWORK MEDICAL GROUP

Practice address

8641 Wilshire Blvd Ste 105
Beverly Hills, CA 90211-2919

Phone

(310) 289-8678

NPI assigned

Jan 10, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ronald Grusd

Title

President

Phone

(310) 289-8678

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1255601076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5355",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902095355",
            "telephone_number": "310-289-8678",
            "fax_number": "310-289-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 WILSHIRE BLVD STE 105",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112919",
            "telephone_number": "310-289-8678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA IMAGING NETWORK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "GRUSD",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-289-8678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.