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General NPI Number Information
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NPI Number | 1396933156
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Entity Type | Organization
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Legal Business Name | BEVERLY RADIOLOGY MEDICAL GROUP III
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 16130 VENTURA BLVD SUITE 100
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City | ENCINO
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State | CA
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Zip | 91436-2503
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Country | US
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Telephone | 310-445-2800
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Fax | 310-479-1459
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Provider Business Mailing Address
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Address Line | PO BOX 101418
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City | PASADENA
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State | CA
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Zip | 91189-0025
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Country | US
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Telephone | 844-866-2718
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HOWARD G BERGER
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Credential | M.D.
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Telephone | 844-866-2718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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