Organization Active NPI

Millennium Medical Imaging Center, a Medical Corporation

  • Diagnostic Radiology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1982724829
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G798070 Issued in CA
Legal business name
MILLENNIUM MEDICAL IMAGING CENTER, A MEDICAL CORPORATION
Practice address
11088 Elm Ave
Rancho Cucamonga, CA 91730-7676
Phone
(909) 625-2000
Fax
(909) 625-2099
NPI assigned
Mar 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Dr. Camiar Ohadi, MDNPI 1063582112
Title
Medical Radiologist
Phone
(909) 625-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X G798070 CA Primary

Addresses

Primary practice location

11088 Elm Ave
Rancho Cucamonga, CA 91730-7676

Mailing address

11088 Elm Ave
Rancho Cucamonga, CA 91730-7676
Phone (909) 625-2000

Other identifiers 1

IdentifierTypeStateIssuer
2832233MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091007000166 CA Part B Supplier - Clinic/Group Practice 9032255930 Receives reassigned benefits from 2 practitioners
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory

Locations

9655 Monte Vista Ave
Ste 403
Montclair, CA 91763
Phone (909) 621-7321

11088 Elm Ave
Rch Cucamonga, CA 91730
Phone (909) 625-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1982724829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11088 ELM AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307676",
            "telephone_number": "909-625-2000",
            "fax_number": "909-625-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11088 ELM AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307676",
            "telephone_number": "909-625-2000",
            "fax_number": "909-625-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM MEDICAL IMAGING CENTER, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-31",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "OHADI",
        "authorized_official_first_name": "CAMIAR",
        "authorized_official_title_or_position": "MEDICAL RADIOLOGIST",
        "authorized_official_telephone_number": "909-625-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G798070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2832233",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.