Active NPI
Desert Advanced Imaging Medical Center
- Diagnostic Radiology Physician
- Indio, CA
National Provider Identifier
1801841242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- Legal business name
- DESERT ADVANCED IMAGING MEDICAL CENTER
- Practice address
- 81880 Dr Carreon Blvd
Suite A102
Indio, CA 92201-5559 - Phone
- (760) 863-3857
- Fax
- (760) 863-5249
- NPI assigned
- May 24, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | Primary |
Addresses
Primary practice location
81880 Dr Carreon Blvd
Suite A102
Indio, CA 92201-5559
Mailing address
1037 N Grand Ave
PMB 203
Covina, CA 91724-2048
Phone (760) 863-3857
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ01739Z | Other | CA | BLUE SHIELD |
| GR0092474 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Desert Advanced Med Center
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Diagnostic Radiology Physician
- Palm Springs, CA
- NPI 1518906783
-
- Diagnostic Radiology Physician
- Bermuda Dunes, CA
- NPI 1629023916
-
- Diagnostic Radiology Physician
- Palm Springs, CA
- NPI 1598719759
-
dba Desert Advanced PET Center
- Diagnostic Radiology Physician
- Palm Springs, CA
- NPI 1932154978
Locations
1037 N Grand Ave
Covina, CA 91724
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": "1801841242",
"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": "760-863-3857",
"fax_number": "760-863-5249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81880 DR CARREON BLVD",
"address_2": "SUITE A102",
"city": "INDIO",
"state": "CA",
"postal_code": "922015559",
"telephone_number": "760-863-3857",
"fax_number": "760-863-5249"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DESERT ADVANCED IMAGING MEDICAL 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": "",
"desc": "Radiology, Diagnostic Radiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ01739Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0092474",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indio, 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.