Provider Demographics
NPI:1821853094
Name:BERGMAN, ERIC JAMES (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JAMES
Last Name:BERGMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BATRIS CT
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1872
Mailing Address - Country:US
Mailing Address - Phone:818-216-9052
Mailing Address - Fax:
Practice Address - Street 1:23101 SHERMAN PL STE 515
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2052
Practice Address - Country:US
Practice Address - Phone:747-900-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist