Basic Information
| Provider Information | |||||||||
| NPI: | 1922342047 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BERKELEY ORTHOPAEDIC CONSULTANTS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3511 DEL PASO RD., STE 160-101 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958352808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162674097 | ||||||||
| FaxNumber: | 9164922111 | ||||||||
| Practice Location | |||||||||
| Address1: | 2825 J ST STE 440 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958164300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9162674097 | ||||||||
| FaxNumber: | 9164922111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2012 | ||||||||
| LastUpdateDate: | 11/15/2012 | ||||||||
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| AuthorizedOfficialLastName: | JAMALI | ||||||||
| AuthorizedOfficialFirstName: | AMIR | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9162674097 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | A061055 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.