Organization
BEVERLY RADIOLOGY MEDICAL GROUP
Active
Other names
BURBANK ADVANCED IMAGING CENTER MED GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD G BERGER MD (PRESIDENT)
(310) 445-2800
Entity
Organization
Contact information
Practice address
10101 RIVERSIDE DR, TOLUCA LAKE, CA 91602-2517
(818) 762-2626
(818) 762-0288
Mailing address
PO BOX 240086, LOS ANGELES, CA 90024-9186
(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
01
—
ZZZ03078Z
BLUE SHIELD
CA
Enumeration date
05/20/2006
Last updated
08/22/2020
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