NPIMap

Organization Active NPI

Beaumont Radiology Services LLC

  • Radiology Clinic/Center
  • Beaumont, CA
National Provider Identifier
1629212840
Registry record updated May 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
BEAUMONT RADIOLOGY SERVICES LLC
Practice address
81 S. Highland Springs Avenue
Suite 102
Beaumont, CA 92223
Phone
(949) 395-4536
Fax
(949) 364-2632
NPI assigned
May 1, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2009

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

Authorized official

Name
Mr. Daniel E Fontoura
Title
Chairman
Phone
(909) 558-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

81 S. Highland Springs Avenue
Suite 102
Beaumont, CA 92223

Mailing address

10 Vienna
Newport Beach, CA 92660-6832
Phone (949) 395-4536

Other names 1

  • Highland Springs Imaging Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100407000160 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 0749316362 Practice locations: Beaumont, CA

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

File 749355
Los Angeles, CA 90074

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241136000000",
    "number": "1629212840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 VIENNA",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926606832",
            "telephone_number": "949-395-4536",
            "fax_number": "949-364-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 S. HIGHLAND SPRINGS AVENUE",
            "address_2": "SUITE 102",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "92223",
            "telephone_number": "949-395-4536",
            "fax_number": "949-364-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT RADIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2009-05-01",
        "status": "A",
        "authorized_official_last_name": "FONTOURA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "909-558-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Springs Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.