BEVERLY RADIOLOGY MEDICAL GROUP (NPI# 1366766180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366766180 |
| Entity Type | Organization |
| Organization Name | BEVERLY RADIOLOGY MEDICAL GROUP |
| Other Organization Name | BURBANK IMAGING CENTER |
| Practice Address |
201 S Buena Vista St Suite #315 Burbank CA 91505-4569 |
| Practice Telephone | 8188437462 |
| Mailing Telephone | 8188437462 |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2011-06-13 |
| Authorized Official Name | DR. HOWARD G. BERGER (CEO & PRESIDENT) |
| Authorized Official Telephone | 3104452800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G19870 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE GROUP PTAN | W22324A | 01 |
| Other Name | Type Code |
|---|---|
| Burbank Imaging Center | 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 |
| 1962456129 | Beverly Radiology Medical Group | Radiology | 10101 Riverside Dr, Toluca Lake, CA 91602-2517 | 2006-05-20 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Beverly Radiology Medical Group | 1510 Cotner Ave, Los Angeles, CA 90025 |
| Street Address |
201 S BUENA VISTA ST SUITE #315 |
| City | BURBANK |
| State | CA |
| Zip Code | 91505-4569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902801301 | Bruce M Stark | Internal Medicine | 201 S Buena Vista St, Suite 300, Burbank, CA 91505-4569 | 2005-06-14 |
| 1124569009 | Advanced Pain Medical Group | Anesthesiology | 201 S Buena Vista St, Suite 300, Burbank, CA 91505-4569 | 2017-03-13 |
| 1477097558 | Advanced Pain Medical Group, Inc | Non-Pharmacy Dispensing Site | 201 S Buena Vista St, Suite 300, Burbank, CA 91505-4569 | 2016-12-08 |
| 1598213969 | Elena Absalon | Physical Therapist | 201 S Buena Vista St, Suite 355, Burbank, CA 91505-4569 | 2016-09-14 |
| 1255721478 | Sarang Medical Corporation | Internal Medicine | 201 S Buena Vista St, Ste#250, Burbank, CA 91505-4569 | 2015-01-26 |
| 1306253687 | Pacific Accountable Care Network Inc | General Practice | 201 S Buena Vista St, Suite 425, Burbank, CA 91505-4569 | 2014-07-17 |
| 1881009108 | R Ajakwe Md and R Tatevossian Md A Professional Medical Corporation | Pain Medicine | 201 S Buena Vista St, Suite 238, Burbank, CA 91505-4569 | 2014-06-25 |
| 1063845782 | Alexander S Tovar Md A Professional Corporation | Specialist | 201 S Buena Vista St, #425, Burbank, CA 91505-4569 | 2013-08-16 |
| 1487090973 | Michael George Wheeler | Podiatrist | 201 S Buena Vista St, Suite 305, Burbank, CA 91505-4569 | 2013-05-11 |
| 1477828671 | Kimberly Sinclair | Nurse Practitioner | 201 S Buena Vista St, Suite #425, Burbank, CA 91505-4569 | 2012-03-21 |
| Find all providers in the same location | ||||
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|---|---|---|---|---|
| 1023625035 | K and S Hospice Inc | Hospice Care, Community Based | 4100 W Alameda Ave Fl 3, Burbank, CA 91505 | 2020-09-24 |
| 1013542471 | Jami Stehlin | Nurse Practitioner | 501 S. Buena Vista St. 3ne, Burbank, CA 91505 | 2020-03-06 |
| 1497309033 | Ibrahim Lala | Pharmacist | 181 S. Buena Vista St, Burbank, CA 91505 | 2019-08-01 |
| 1720501240 | Jung H Li | Registered Nurse | Psjmc- Bariatric Wellness Center, 501 S Buena Vista St, Burbank, CA 91505 | 2017-07-18 |
| 1699204974 | Beth Ellen Izbotsky | Physical Medicine & Rehabilitation | 501 S Buena Vista Blvd, Burbank, CA 91505 | 2017-06-08 |
| 1205387446 | Fabiola Bachman | Dentist | 138 N Pass Ave, 2, Burbank, CA 91505 | 2016-10-24 |
| 1114478203 | Marianna Ghularyan D.d.s. Inc | Dentist | 1400 N. Edison Blvd., Burbank, CA 91505 | 2016-10-24 |
| 1962952127 | Landa Mizin Dental Partnership | Dentist | 2625 W Alameda Ave Ste 502, Burbank, CA 91505 | 2016-10-11 |
| 1285183376 | Amy Di Francia | Marriage & Family Therapist | 4421 W Riverside Dr Ste 210, Burbank, CA 91505 | 2016-09-29 |
| 1306238381 | Abigail Merrin | Physical Therapist | 2701 W Alameda Ave Ste 206, Burbank, CA 91505 | 2015-02-26 |
| Find all providers in zip 91505 | ||||
| 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 |
|---|---|---|---|---|
| 1972080356 | Los Alamitos Radiology Group Inc | Radiology | 3406 Kildare Ct, Burbank, CA 91504-1665 | 2018-07-27 |
| 1316205644 | J. Bruce Jacobs, M.d., Inc. | Radiology | 1821 W Olive Ave, Burbank, CA 91506-2435 | 2012-04-24 |
| 1659678654 | Samuel Tokuyama | Radiology | 855 Brown Dr, Burbank, CA 91504-1838 | 2011-02-28 |
| 1376586990 | Marc Lee | Radiology | 1624 West Olive Ave, Suite F, Burbank, CA 91505 | 2006-06-13 |
| 1881698819 | Laurie Anne Cleland | Radiology | 1624 W Olive Ave, Suite F, Burbank, CA 91506-2459 | 2005-06-08 |
| 1134424005 | Reono Bertagnolli A Medical Group | Radiology | 2820 N Ontario St, Burbank, CA 91504-2015 | 2011-01-24 |
| 1740493048 | Wendy Chern Wan Tien | Radiology | 1624 W Olive Ave, Suite F, Burbank, CA 91506-2459 | 2007-05-07 |
| 1114943446 | Norman Robert Silverman | Radiology | 2820 N Ontario St, Burbank, CA 91504-2015 | 2006-07-13 |
| 1700811312 | Edward J Jahnke IIi | Radiology | 501 S Buena Vista St, Burbank, CA 91505-4809 | 2006-07-12 |
| 1871547034 | Beverly Radiology Medical Group | Radiology | 3808 W Riverside Dr, Suite 120, Burbank, CA 91505-4325 | 2006-05-20 |
| Find all providers in BURBANK | ||||
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| 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.