Provider Demographics
NPI:1265783948
Name:RHEUMATOLOGY SERVICES MEDICAL GROUP
Entity type:Organization
Organization Name:RHEUMATOLOGY SERVICES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-695-8385
Mailing Address - Street 1:8329 BRIMHALL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2243
Mailing Address - Country:US
Mailing Address - Phone:661-695-8385
Mailing Address - Fax:661-679-6801
Practice Address - Street 1:8329 BRIMHALL RD STE 801
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-2243
Practice Address - Country:US
Practice Address - Phone:661-695-8385
Practice Address - Fax:661-679-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11715207RR0500X
CAG29499207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGU585AOtherMEDICARE PTAN
CA0101340Medicaid
CADT5405OtherMEDICARE RAILROAD
CADT5405OtherMEDICARE RAILROAD