Organization
DIAGNOSTIC RADIOLOGICAL IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD G BERGER MD (PRESIDENT)
(310) 445-2800
Entity
Organization
Contact information
Practice address
79 SCRIPPS DR, SACRAMENTO, CA 95825-6208
(916) 921-1300
(916) 921-1095
Mailing address
79 SCRIPPS DR, SACRAMENTO, CA 95825-6208
(916) 921-1300
(916) 921-1095
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0020320
—
CA
01
—
ZZZ96718Z
BLUE SHIELD
CA
Enumeration date
05/20/2006
Last updated
12/21/2015
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