Provider Demographics
NPI:1699856039
Name:HALLBERG, MARIJKE BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIJKE
Middle Name:BARBARA
Last Name:HALLBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 52ND STREET (ED-II)
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-628-3522
Mailing Address - Fax:510-450-5696
Practice Address - Street 1:747 52ND STREET (ED-II)
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1809
Practice Address - Country:US
Practice Address - Phone:510-628-3522
Practice Address - Fax:510-450-5696
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65568282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren