Provider Demographics
NPI:1629703301
Name:BERMAN NEUROSURGERY INC
Entity Type:Organization
Organization Name:BERMAN NEUROSURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:909-477-0894
Mailing Address - Street 1:2968 STABLE PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2409
Mailing Address - Country:US
Mailing Address - Phone:909-477-0894
Mailing Address - Fax:
Practice Address - Street 1:27455 TIERRA ALTA WAY
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3498
Practice Address - Country:US
Practice Address - Phone:909-477-0894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty