Provider Demographics
NPI:1881971299
Name:NORCAL IMAGING
Entity type:Organization
Organization Name:NORCAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-445-2800
Mailing Address - Street 1:2999 REGENT ST.
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2117
Mailing Address - Country:US
Mailing Address - Phone:510-704-7760
Mailing Address - Fax:585-241-6872
Practice Address - Street 1:2999 REGENT ST.
Practice Address - Street 2:SUITE 225
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2117
Practice Address - Country:US
Practice Address - Phone:510-704-7760
Practice Address - Fax:585-241-6872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ05319ZOtherMEDICARE GROUP PTAN