Active NPI
Rancho Bernardo Advanced Imaging
- Diagnostic Radiology Physician
- San Diego, CA
National Provider Identifier
1801934070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0093210 | Medicaid | CA | |
| ZZZ05125Z | Other | CA | BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Diagnostic Radiology Physician
- Carlsbad, CA
- NPI 1083713002
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.