NPIMap

Organization Active NPI

Desert Advanced Imaging Center

  • Diagnostic Radiology Physician
  • Bermuda Dunes, CA
National Provider Identifier
1629023916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
DESERT ADVANCED IMAGING CENTER
Practice address
41120 Washington St
JFK 2ND Floor
Bermuda Dunes, CA 92203-9215
Phone
(760) 200-4168
Fax
(760) 200-4387
NPI assigned
May 24, 2006
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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

41120 Washington St
JFK 2ND Floor
Bermuda Dunes, CA 92203-9215

Mailing address

1037 N Grand Ave
PMB 203
Covina, CA 91724-2048
Phone (626) 966-1580

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ01737ZOtherCABLUE SHIELD
GR0092473MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Desert Advanced Med Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629023916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 N GRAND AVE",
            "address_2": "PMB 203",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917242048",
            "telephone_number": "626-966-1580",
            "fax_number": "626-967-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41120 WASHINGTON ST",
            "address_2": "JFK 2ND FLOOR",
            "city": "BERMUDA DUNES",
            "state": "CA",
            "postal_code": "922039215",
            "telephone_number": "760-200-4168",
            "fax_number": "760-200-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT ADVANCED IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ01737Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092473",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bermuda Dunes, 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.