Provider Demographics
NPI:1912241019
Name:DAVID BERGER MD INC.
Entity Type:Organization
Organization Name:DAVID BERGER MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-861-0336
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-861-0336
Mailing Address - Fax:562-923-7941
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:562-861-0336
Practice Address - Fax:562-923-7941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27322207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A43323Medicare UPIN