Basic Information
| Provider Information | |||||||||
| NPI: | 1548245921 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERMAN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1341 S ELISEO DR | ||||||||
| Address2: | |||||||||
| City: | GREENBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949042000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154648169 | ||||||||
| FaxNumber: | 4154648177 | ||||||||
| Practice Location | |||||||||
| Address1: | 1341 S ELISEO DR | ||||||||
| Address2: | |||||||||
| City: | GREENBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 949042000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154648169 | ||||||||
| FaxNumber: | 4154648177 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G20952 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.