Provider Demographics
NPI:1003056821
Name:PIZZO-BERKEY, ALLYSON JEAN (MD)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:JEAN
Last Name:PIZZO-BERKEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:JEAN
Other - Last Name:BERKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:351 HOSPITAL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3509
Mailing Address - Country:US
Mailing Address - Phone:949-612-7430
Mailing Address - Fax:949-612-7431
Practice Address - Street 1:351 HOSPITAL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3509
Practice Address - Country:US
Practice Address - Phone:949-612-7430
Practice Address - Fax:949-612-7431
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG077666208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF69835OtherUPIN
CA1841749041Medicare UPIN