Provider Demographics
NPI:1225009822
Name:BERKMAN, GERALD CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:CHARLES
Last Name:BERKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32144 AGOURA RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:818-889-8387
Mailing Address - Fax:818-889-0272
Practice Address - Street 1:32144 AGOURA RD
Practice Address - Street 2:SUITE 211
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:818-889-8387
Practice Address - Fax:818-889-0272
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG210152080A0000X, 2080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Not Answered2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A90677Medicare UPIN