NPIMap

Organization Active NPI

Beverly Radiology Medical Group

  • Diagnostic Radiology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1942255807
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BEVERLY RADIOLOGY MEDICAL GROUP
Practice address
8283 Grove Ave
Suite 101
Rancho Cucamonga, CA 91730-3137
Phone
(909) 982-8638
Fax
(909) 920-0640
NPI assigned
May 22, 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

8283 Grove Ave
Suite 101
Rancho Cucamonga, CA 91730-3137

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ05211ZOtherCABLUE SHIELD
GR0092131MedicaidCA

Other names 1

  • Grove Diagnostic Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beverly Radiology Medic III14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942255807",
    "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": "8283 GROVE AVE",
            "address_2": "SUITE 101",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303137",
            "telephone_number": "909-982-8638",
            "fax_number": "909-920-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "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": "ZZZ05211Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grove Diagnostic Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, 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.