Basic Information
| Provider Information | |||||||||
| NPI: | 1649260613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERLINER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | SAMUEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 417 E KIOWA ST | ||||||||
| Address2: | #1202 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809033410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7194347219 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3205 N ACADEMY BLVD | ||||||||
| Address2: | SUITE 160 | ||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809175101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7197763216 | ||||||||
| FaxNumber: | 7197763187 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 10/29/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | G41348 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | DR 0020914 | CO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.