Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 221661 | NY |
N | 207RC0200X | Critical Care Medicine | A94638 | CA |
N | 207RP1001X | Pulmonary Disease | 221661 | NY |
Y | 207RP1001X | Pulmonary Disease | A94638 | CA |
NPI | 1023135761 |
---|---|
Provider Name | Dr. Vala Berjis |
First Address | Walnut Creek, CA 94598-2883 |
Second Address | New York, NY 10019-1147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 25/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
127323 | (02) | NY |