Provider Demographics
NPI:1679554778
Name:BERMAN, JOEL F (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:F
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 ALTURAS ST
Mailing Address - Street 2:STE 5
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4144
Mailing Address - Country:US
Mailing Address - Phone:530-742-0365
Mailing Address - Fax:530-742-3338
Practice Address - Street 1:415 ALTURAS ST
Practice Address - Street 2:STE 5
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4144
Practice Address - Country:US
Practice Address - Phone:530-742-0365
Practice Address - Fax:530-742-3338
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3476213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E34761Medicaid
000E34761Medicare ID - Type Unspecified
000E34760Medicare ID - Type Unspecified
CA000E34761Medicaid
000E34762Medicare ID - Type Unspecified