NPIMap

Organization Active NPI

Victor Valley Advanced Imaging

  • Diagnostic Radiology Physician
  • Victorville, CA
National Provider Identifier
1497941264
Registry record updated Jun 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
VICTOR VALLEY ADVANCED IMAGING
Practice address
15247 Eleventh St
Suite 700
Victorville, CA 92395-3727
Phone
(310) 445-2851
Fax
(310) 479-1459
NPI assigned
Sep 14, 2007
Last updated
Jun 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2009

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

Authorized official

Name
Dr. Howard G. Berger, M.D.
Title
President
Phone
(310) 445-2851

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

15247 Eleventh St
Suite 700
Victorville, CA 92395-3727

Mailing address

1516 Cotner Ave
Los Angeles, CA 90025-3303
Phone (310) 445-2851

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202001145 CA Part B Supplier - Clinic/Group Practice 3476466376 Receives reassigned benefits from 330 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1497941264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 COTNER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900253303",
            "telephone_number": "310-445-2851",
            "fax_number": "310-479-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15247 ELEVENTH ST",
            "address_2": "SUITE 700",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923953727",
            "telephone_number": "310-445-2851",
            "fax_number": "310-479-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR VALLEY ADVANCED IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2009-06-03",
        "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": "310-445-2851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.