Provider Demographics
NPI:1235388828
Name:BERKMAN, SUZANNE LAUREN (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LAUREN
Last Name:BERKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:LAUREN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8920 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 545
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2007
Mailing Address - Country:US
Mailing Address - Phone:310-854-3003
Mailing Address - Fax:310-854-0811
Practice Address - Street 1:8920 WILSHIRE BLVD
Practice Address - Street 2:SUITE 545
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2007
Practice Address - Country:US
Practice Address - Phone:310-854-3003
Practice Address - Fax:310-854-0811
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037491207R00000X
CAA124089207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine