Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | C35918 | CA |
NPI | 1538260583 |
---|---|
Provider Name | Dr. William Ezial Berger |
First Address | Mission Viejo, CA 92691-6410 |
Second Address | Mission Viejo, CA 92691-6410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A87830 | (02) | CA |