Provider Demographics
NPI:1720032881
Name:RADNET MANAGEMENT I, INC.
Entity type:Organization
Organization Name:RADNET MANAGEMENT I, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position: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 1:79 SCRIPPS DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6208
Mailing Address - Country:US
Mailing Address - Phone:916-921-1300
Mailing Address - Fax:916-921-1095
Practice Address - Street 1:6001 SHELLMOUND ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1958
Practice Address - Country:US
Practice Address - Phone:510-601-7979
Practice Address - Fax:510-420-3484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ00724ZOtherBLUE SHIELD
CAGR0089351Medicaid
CAZZZ00724ZOtherBLUE SHIELD