| Organization Name: | BEVERLY RADIOLOGY MEDICAL GROUP |
| NPI Number: | 1285867887 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HAROLD G. BERGER (CEO & PRESIDENT) |
| Mailing Address: | 222 E Main St Suites 213 & 214 Barstow |
| State: | CA US |
| Postal Code: | 923112361 |
| Phone Number: | 7602424444 |
| Fax Number: | 7602427288 |
| NPI Enumeration Date: | 08/29/2009 |
| NPI Last Update Date: | 08/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 23105 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |