Organization
BEVERLY RADIOLOGY MEDICAL GROUP
Active
Other names
BURBANK ADVANCED IMAGING CENTER MED GRP
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD G BERGER MD (PRESIDENT)
(310) 445-2800
Entity
Organization
Contact information
Practice address
3808 W RIVERSIDE DR, SUITE 120, BURBANK, CA 91505-4325
(818) 842-5742
(818) 842-1369
Mailing address
PO BOX 240086, LOS ANGELES, CA 90024-9186
(310) 445-2800
(310) 445-2816
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ07537Z
BLUE SHIELD
CA
Enumeration date
05/20/2006
Last updated
08/22/2020
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