Organization
BEVERLY RADIOLOGY MEDICAL GROUP
Active
Other names
Grove Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD G. BERGER MD (PRESIDENT)
(310) 445-2800
Entity
Organization
Contact information
Practice address
8283 GROVE AVE, SUITE 101, RANCHO CUCAMONGA, CA 91730-3137
(909) 982-8638
(909) 920-0640
Mailing address
1037 N GRAND AVE, PMB 203, COVINA, CA 91724-2048
(626) 966-1580
(626) 967-7821
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0092131
—
CA
01
—
ZZZ05211Z
BLUE SHIELD
CA
Enumeration date
05/22/2006
Last updated
08/22/2020
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