Basic Information
| Provider Information | |||||||||
| NPI: | 1568566891 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEVEN H. BERLIN, M.D. INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2866 | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905092866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107920601 | ||||||||
| FaxNumber: | 3107929062 | ||||||||
| Practice Location | |||||||||
| Address1: | 3828 DELMAS TERRACE | ||||||||
| Address2: | |||||||||
| City: | CULVER CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108367000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BERLIN | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | H. | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3107920601 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | G48861 | CA | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00G488612 | 05 | CA | MEDICAID |