Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G31442 | CA |
NPI | 1013019371 |
---|---|
Provider Name | Dr. Ronald Stuart Berman |
First Address | Arcata, CA 95521-4742 |
Second Address | Arcata, CA 95521-4742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 25/08/2014 |