Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 20A13747 | CA |
N | 207QS0010X | Family Doctor - Sports Medicine | 20A13747 | CA |
NPI | 1033406574 |
---|---|
Provider Name | Dr. Sagir Girish Bera |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Burbank, CA 91505-4044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 01/11/2019 |