Provider Demographics
NPI:1629396916
Name:BERGER, JOEL M (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:BERGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3944 HAMILTON PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1220
Mailing Address - Country:US
Mailing Address - Phone:408-984-5316
Mailing Address - Fax:
Practice Address - Street 1:20410 TOWN CENTER LN STE 150
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-3230
Practice Address - Country:US
Practice Address - Phone:408-973-9586
Practice Address - Fax:408-446-2803
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21580111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology