Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 21580 | CA |
NPI | 1629396916 |
---|---|
Provider Name | Dr. Joel M Berger |
First Address | San Jose, CA 95130-1220 |
Second Address | Cupertino, CA 95014-3230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2010 |
Last Update Date | 11/05/2010 |