Provider Demographics
NPI:1790724490
Name:BERMAN, JOEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11100 WARNER AVE
Mailing Address - Street 2:108
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-7506
Mailing Address - Country:US
Mailing Address - Phone:714-979-3201
Mailing Address - Fax:714-979-1406
Practice Address - Street 1:11100 WARNER AVE
Practice Address - Street 2:108
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-7506
Practice Address - Country:US
Practice Address - Phone:714-979-3201
Practice Address - Fax:714-979-1406
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG24685208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G246851Medicaid
CA00G246851Medicaid
CAA90886Medicare UPIN