Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 000000G21754 | CA |
NPI | 1295815371 |
---|---|
Provider Name | Michael L Berman |
First Address | Los Angeles, CA 90051-3980 |
Second Address | Orange, CA 92868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 30/11/2007 |