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NPI Code Detail

MEDICARE: BEVERLY RADIOLOGY MEDICAL GROUP III

MEDICARE: BEVERLY RADIOLOGY MEDICAL GROUP III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician

General Provider Information

NPI Number : 1962457812
Entity Type Code : Organization
Provider Name (Legal Business Name) : BEVERLY RADIOLOGY MEDICAL GROUP III
Provider Business Mailing Address
First Line : 1510 COTNER AVE.
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-3303
Country : US
Telephone Number : 310-445-2800
Fax Number : 310-479-1459
Provider Business Practice Location Address
First Line : 1510 COTNER AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-3303
Country : US
Telephone Number : 310-445-2951
Fax Number : 310-479-1459
Authorized Official
Title or Position : CEO & PRESIDENT
Name : DR. HOWARD G. BERGER
Credential : M.D.
Telephone Number : 310-445-2800
Provider Enumeration Date : 05/22/2006
Last Update Date : 04/01/2025

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Directions to “BEVERLY RADIOLOGY MEDICAL GROUP III ” Practice Location

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