NPIMap

Organization Active NPI

Socal Mr Site Management, Inc.

  • Diagnostic Radiology Physician
  • Covina, CA
National Provider Identifier
1396774022
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SOCAL MR SITE MANAGEMENT, INC.
Practice address
740 E Arrow Hwy
Suite a
Covina, CA 91722-2144
Phone
(626) 966-1580
Fax
(626) 967-7821
NPI assigned
Jul 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

740 E Arrow Hwy
Suite a
Covina, CA 91722-2144

Mailing address

1037 N Grand Ave PMB 203
Covina, CA 91724-2048
Phone (310) 445-2800

Other identifiers 6

IdentifierTypeStateIssuer
GR0090661MedicaidCA
ZZZ23491ZOtherCABLUE SHIELD
GR0059840MedicaidCA
GR0090660MedicaidCA
ZZZ19215ZOtherCABLUE SHIELD
ZZZ45829ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

740 E Arrow Hwy
Ste A
Covina, CA 91722
Phone (626) 966-1580

18360 Burbank Blvd
Tarzana, CA 91356
Phone (818) 708-5614

18360 Burbank Blvd
Tarzana, CA 91356
Phone (818) 774-9080

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396774022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 N GRAND AVE PMB 203",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242048",
            "telephone_number": "310-445-2800",
            "fax_number": "310-445-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E ARROW HWY",
            "address_2": "SUITE A",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917222144",
            "telephone_number": "626-966-1580",
            "fax_number": "626-967-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL MR SITE MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "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": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090661",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ23491Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059840",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0090660",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ19215Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ45829Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, 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.

Verify at the official NPI Registry.