Provider Demographics
NPI:1700967361
Name:BERMAN, RONALD H (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:H
Last Name:BERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2023 VALE ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806
Mailing Address - Country:US
Mailing Address - Phone:510-235-1723
Mailing Address - Fax:510-235-1700
Practice Address - Street 1:2023 VALE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806
Practice Address - Country:US
Practice Address - Phone:510-235-1723
Practice Address - Fax:510-235-1700
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC27773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C277730Medicaid
CA00C277730Medicaid
CA00C277730Medicare PIN