Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | G21015 | CA |
N | 2080P0210X | Pediatric Nephrologist | G21015 | CA |
NPI | 1225009822 |
---|---|
Provider Name | Gerald Charles Berkman |
First Address | Westlake Village, CA 91361 |
Second Address | Westlake Village, CA 91361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A90677 | (02) |