Provider Demographics
NPI:1215069430
Name:THE RADIOLOGY GROUP INC.
Entity type:Organization
Organization Name:THE RADIOLOGY GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-954-7835
Mailing Address - Street 1:94-800 UKEE STREET
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-454-5200
Mailing Address - Fax:808-454-5201
Practice Address - Street 1:94-800 UKEE STREET
Practice Address - Street 2:SUITE 303
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-454-5200
Practice Address - Fax:808-454-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000WCCBNMedicare PIN