Provider Demographics
NPI:1417389271
Name:BERGER, SAUL (MD)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:BERGER
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 1:616 E. GLENOAKS BLVD.
Mailing Address - Street 2:STE 202
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207-1778
Mailing Address - Country:US
Mailing Address - Phone:818-245-6101
Mailing Address - Fax:818-245-6062
Practice Address - Street 1:616 E. GLENOAKS BLVD.
Practice Address - Street 2:STE 202
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91207-1778
Practice Address - Country:US
Practice Address - Phone:818-245-6101
Practice Address - Fax:818-245-6062
Is Sole Proprietor?:No
Enumeration Date:2013-08-04
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG062436208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery