San Bernardino Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

SAN BERNARDINO IMAGING LLC

Practice address

1884 Business Center Dr
San Bernardino, CA 92408-3457

Phone

(909) 890-4090

Fax

(909) 890-4051

NPI assigned

Aug 9, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lavelle Hardin

Title

Credentialing Coordinator

Phone

(615) 344-8203

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Computerized Diagnostic Imaging Centers - San Bernardino Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymond P. Sakover, MD

  • Diagnostic Radiology Physician
  • Riverside, CA
  • NPI 1578564431
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1164423612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1884 BUSINESS CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083457",
            "telephone_number": "909-890-4090",
            "fax_number": "909-890-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1884 BUSINESS CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083457",
            "telephone_number": "909-890-4090",
            "fax_number": "909-890-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN BERNARDINO IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "HARDIN",
        "authorized_official_first_name": "LAVELLE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "615-344-8203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00385820",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTF00700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Computerized Diagnostic Imaging Centers - San Bernardino",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Radiology Clinic/Center in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.