Basic Information
| Provider Information | |||||||||
| NPI: | 1538479753 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERGER | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7801 MISSION CENTER CT STE 250 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921081314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6197385566 | ||||||||
| FaxNumber: | 6195660202 | ||||||||
| Practice Location | |||||||||
| Address1: | 230 PROSPECT PL STE 340B | ||||||||
| Address2: | |||||||||
| City: | CORONADO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195224000 | ||||||||
| FaxNumber: | 6194350150 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2010 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | NP700172 | CA | N | Nursing Service Providers | Registered Nurse | 363LA2200X | NP19912 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LA2200X | NP 19912 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.