Provider Demographics
NPI:1972047686
Name:BARRY M. KERMAN, MD, INC.
Entity Type:Organization
Organization Name:BARRY M. KERMAN, MD, INC.
Other - Org Name:CASTRO VALLEY EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODERICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-538-5297
Mailing Address - Street 1:21675 REDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-6431
Mailing Address - Country:US
Mailing Address - Phone:510-538-5252
Mailing Address - Fax:
Practice Address - Street 1:21675 REDWOOD RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-6431
Practice Address - Country:US
Practice Address - Phone:510-538-5252
Practice Address - Fax:510-538-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21061207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty