Provider Demographics
NPI:1831471549
Name:BERGER, IRVIN ABRAHAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IRVIN
Middle Name:ABRAHAM
Last Name:BERGER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9811 W CHARLESTON BLVD
Mailing Address - Street 2:#2-878
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7528
Mailing Address - Country:US
Mailing Address - Phone:818-519-1949
Mailing Address - Fax:702-685-3443
Practice Address - Street 1:6865 W TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4383
Practice Address - Country:US
Practice Address - Phone:702-871-1623
Practice Address - Fax:702-871-3314
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17215183500000X
CA31066183500000X
UT7296658-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist