Organization Active NPI

Rancho Bernardo Advanced Imaging

  • Diagnostic Radiology Physician
  • San Diego, CA
National Provider Identifier
1801934070
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RANCHO BERNARDO ADVANCED IMAGING
Practice address
17065 Camino San Bernardo BLDG 400
Suite 100
San Diego, CA 92127-5709
Phone
(858) 592-2369
Fax
(858) 592-2653
NPI assigned
Feb 1, 2007
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
Dr. Howard G. Berger, MD
Title
President
Phone
(310) 445-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X CA Primary

Addresses

Primary practice location

17065 Camino San Bernardo BLDG 400
Suite 100
San Diego, CA 92127-5709

Mailing address

PO Box 240086
Los Angeles, CA 90024-9186
Phone (310) 445-2800

Other identifiers 2

IdentifierTypeStateIssuer
GR0093210MedicaidCA
ZZZ05125ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

17065 Camino San Bernardo
Ste 100
San Diego, CA 92127
Phone (858) 592-2369

17065 Camino San Bernardo
Bldg 400
San Diego, CA 92127
Phone (858) 592-2369

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801934070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 240086",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900249186",
            "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": "17065 CAMINO SAN BERNARDO BLDG 400",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275709",
            "telephone_number": "858-592-2369",
            "fax_number": "858-592-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO BERNARDO ADVANCED IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0093210",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ05125Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, 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.