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General NPI Number Information
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NPI Number | 1801934070
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Entity Type | Organization
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Legal Business Name | RANCHO BERNARDO ADVANCED IMAGING
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17065 CAMINO SAN BERNARDO BLDG 400 SUITE 100
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City | SAN DIEGO
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State | CA
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Zip | 92127-5709
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Country | US
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Telephone | 858-592-2369
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Fax | 858-592-2653
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Provider Business Mailing Address
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Address Line | PO BOX 240086
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City | LOS ANGELES
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State | CA
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Zip | 90024-9186
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Country | US
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Telephone | 310-445-2800
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Fax | 310-445-2816
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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 | MD
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Telephone | 310-445-2800
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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 | CA
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