Active NPI
Woodward Park Radiology Center Med. GRP
- Diagnostic Radiology Physician
- Fresno, CA
National Provider Identifier
1003840042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- WOODWARD PARK RADIOLOGY CENTER MED. GRP
- Practice address
- 7055 N Fresno St
203
Fresno, CA 93720-2957 - Phone
- (559) 437-1880
- Fax
- (559) 437-1888
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Howard G. Berger, MD
- Title
- President
- Phone
- (310) 445-2800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | CA | Primary |
Addresses
Primary practice location
7055 N Fresno St
203
Fresno, CA 93720-2957
Mailing address
79 Scripps Dr
100
Sacramento, CA 95825-6208
Phone (916) 921-1300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ55191Z | Other | CA | BLUE SHIELD |
| GR0081040 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1003840042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 SCRIPPS DR",
"address_2": "100",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958256208",
"telephone_number": "916-921-1300",
"fax_number": "916-921-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7055 N FRESNO ST",
"address_2": "203",
"city": "FRESNO",
"state": "CA",
"postal_code": "937202957",
"telephone_number": "559-437-1880",
"fax_number": "559-437-1888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WOODWARD PARK RADIOLOGY CENTER MED. GRP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BERGER",
"authorized_official_first_name": "HOWARD",
"authorized_official_middle_name": "G.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-445-2800",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ55191Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0081040",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.