Provider Demographics
NPI:1720311012
Name:BERKLEY, HUGH KLING (PA)
Entity Type:Individual
Prefix:MR
First Name:HUGH
Middle Name:KLING
Last Name:BERKLEY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 WASHBURN AVE
Mailing Address - Street 2:STE 5
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3303
Mailing Address - Country:US
Mailing Address - Phone:951-808-6700
Mailing Address - Fax:
Practice Address - Street 1:760 WASHBURN AVE STE 5/6
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3303
Practice Address - Country:US
Practice Address - Phone:951-808-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-17
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10952363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical