BEVERLY RADIOLOGY MEDICAL GROUP (NPI# 1962456129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962456129 |
| Entity Type | Organization |
| Organization Name | BEVERLY RADIOLOGY MEDICAL GROUP |
| Other Organization Name | BURBANK ADVANCED IMAGING CENTER MED GROUP |
| Practice Address |
10101 Riverside Dr Toluca Lake CA 91602-2517 |
| Mailing Address |
Po Box 240086 Los Angeles CA 90024-9186 |
| Practice Telephone | 8187622626 |
| Practice Fax Number | 8187620288 |
| Mailing Telephone | 6269661580 |
| Mailing Fax Number | 6269677821 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | HOWARD G BERGER (PRESIDENT) |
| Authorized Official Telephone | 3104452800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE SHIELD | ZZZ03078Z | 01 |
| Other Name | Type Code |
|---|---|
| BURBANK ADVANCED IMAGING CENTER MED GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841720059 | Beverly Radiology Medical Group | Radiology | 8540 S Sepulveda Blvd Ste 111, Los Angeles, CA 90045-3810 | 2017-06-20 |
| 1093243404 | Beverly Radiology Medical Group | Radiology | 8227 Reseda Blvd, Reseda, CA 91335-1247 | 2017-05-30 |
| 1477872919 | Beverly Radiology Medical Group | Radiology | 800 E Highland Ave, San Bernardino, CA 92404-4006 | 2010-05-24 |
| 1306884648 | Beverly Radiology Medical Group | Radiology | 43713 20th St W, Lancaster, CA 93534-4628 | 2006-06-02 |
| 1538106752 | Beverly Radiology Medical Group | Radiology | 455 N Roxbury Dr, Beverly Hills, CA 90210-5001 | 2006-05-31 |
| 1710931381 | Beverly Radiology Medical Group | Radiology | 44305 Lorimer Ave, Lancaster, CA 93534-3700 | 2006-05-19 |
| 1043681752 | Beverly Radiology Medical Group | Radiology | 521 E Elder St, Suite 101, Fallbrook, CA 92028-3081 | 2015-10-08 |
| 1164760823 | Beverly Radiology Medical Group | Radiology | 15243 Vanowen St, Van Nuys, CA 91405-3605 | 2013-01-30 |
| 1801159736 | Beverly Radiology Medical Group | Radiology | 1901 W Lugonia Ave, Suite 110, Redlands, CA 92374-9703 | 2012-06-15 |
| 1184981409 | Beverly Radiology Medical Group | Radiology | 15651 Imperial Hwy, Suite 103, La Mirada, CA 90638-1628 | 2012-04-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Beverly Radiology Medical Group | 1510 Cotner Ave, Los Angeles, CA 90025 |
| Street Address |
10101 RIVERSIDE DR |
| City | TOLUCA LAKE |
| State | CA |
| Zip Code | 91602-2517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112882 | Da Oum Remnant Acupuncture Corporation | Acupuncturist | 10674 Riverside Drive, North Hollywood, CA 91602 | 2020-01-06 |
| 1043704927 | Brandi Carter | Nurse Practitioner | 10222 Camarillo St Apt 107, Toluca Lake, CA 91602 | 2018-06-14 |
| 1669904587 | Katelyn Story Kalstein | Naturopath | 11650 Riverside Dr., Ph-2a, Studio City, CA 91602 | 2017-03-30 |
| 1255781118 | Karla Morales | Dental Hygienist | 10707 Camarillo St, #305, West Toluca Lake, CA 91602 | 2016-06-21 |
| 1457738536 | Mallory Garrett | Marriage & Family Therapist | 10737 Riverside Dr, N Hollywood, CA 91602 | 2015-04-28 |
| 1831590322 | Victoria J. Chan | Nurse Practitioner | 4418 Vineland Avenue Suite 102, Toluca Lake, CA 91602 | 2014-09-16 |
| 1679916076 | Richard Villasenor | Ophthalmology | 10520 Camarillo St, Toluca Lake, CA 91602 | 2013-04-16 |
| 1275878233 | Julissa Trusty | Marriage & Family Therapist | 11334 Camarillo St, North Hollywood, CA 91602 | 2012-12-03 |
| 1265789531 | Marina Serobyan | Marriage & Family Therapist | 10999 Riverside Drive, Suite 306, Toluca Lake, CA 91602 | 2012-08-06 |
| 1407133457 | Hearing Aid Counselors, Inc | Durable Medical Equipment & Medical Supplies | 11008 Riverside Dr, Toluca Lake, CA 91602 | 2011-11-04 |
| Find all providers in zip 91602 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467654343 | Somnath Basu | Radiology | 10153 1/2 Riverside Dr, Suite # 580, Toluca Lake, CA 91602-2561 | 2007-06-04 |
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| 1083213151 | Antelope Valley Outpatient Imaging Center, LLC | Radiology | 44105 15th St W Ste 100, Lancaster, CA 93534-4090 | 2020-10-20 |
| 1750980967 | Centrelake Medical Group Inc | Radiology | 430 W Stetson Ave, Hemet, CA 92543-7328 | 2020-10-19 |
| 1538775994 | Richard J. Moran | Radiology | 230 S Main St Ste 101, Orange, CA 92868-3851 | 2020-09-21 |
| 1417567710 | Family Medical Diagnostics Inc | Radiology | 19231 Victory Blvd Ste 356, Reseda, CA 91335-6308 | 2020-08-03 |
| 1396365011 | Prodiagnose Inc | Radiology | 7345 Topanga Canyon Blvd # 210, Canoga Park, CA 91303-1244 | 2020-04-22 |
| 1548892276 | Alvarado Radiology Group Inc, A Professional Corporation | Radiology | 13700 Marina Pointe Dr Unit 430, Marina Del Rey, CA 90292-9277 | 2020-02-11 |
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| Find all providers with the same taxonomy | ||||
| City | TOLUCA LAKE |
| Zip Code | 91602 |
Please comment or provide details below to improve the information on BEVERLY RADIOLOGY MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.