Victor Valley Advanced Imaging
Organization Active NPI Diagnostic Radiology Physician · Victorville, CA
NPI 1497941264 · NPPES record last updated Jun 3, 2009
Key facts
- NPI
- 1497941264
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 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
- Organization subpart
- No
Authorized official
- Name
- Dr. Howard G. Berger, M.D.
- Title
- President
- Phone
- (310) 445-2851
Other NPIs on the same Medicare enrollment 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
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
Other providers in Victorville, CA
- Ginamarie Vianelli
- Victor Community Support Services Inc
- Victor Community Support Services, Inc
- Victor Community Support Services, Inc.
- Victor Elementary Esd
- Victor Valley Anesthesia Medical Group Inc
- Victor Valley Community Dental Service Program
- Victor Valley Community Hospital
- Victor Valley Community Hospital
- Victor Valley Community Hospital
All providers in Victorville, CA · Diagnostic Radiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.