Healthcare Provider Details

I. General information

NPI: 1053460188
Provider Name (Legal Business Name): PITTSBURG OPEN MRI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 E LELAND RD STE D-E
PITTSBURG CA
94565-5100
US

IV. Provider business mailing address

1516 COTNER AVE
LOS ANGELES CA
90025-3303
US

V. Phone/Fax

Practice location:
  • Phone: 925-473-9290
  • Fax: 925-473-9905
Mailing address:
  • Phone: 310-445-2951
  • Fax: 310-479-1459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberFNP35580
License Number StateCA

VIII. Authorized Official

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