Healthcare Provider Details

I. General information

NPI: 1801841242
Provider Name (Legal Business Name): DESERT ADVANCED IMAGING MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81880 DR CARREON BLVD SUITE A102
INDIO CA
92201-5559
US

IV. Provider business mailing address

1037 N GRAND AVE PMB 203
COVINA CA
91724-2048
US

V. Phone/Fax

Practice location:
  • Phone: 760-863-3857
  • Fax: 760-863-5249
Mailing address:
  • Phone: 760-863-3857
  • Fax: 760-863-5249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD G. BERGER
Title or Position: PRESIDENT
Credential: MD
Phone: 310-445-2800