Bergen, Randy E.

Bergen, Randy E. is an individual health care provider with primary practice located at 1425 S Main St , Walnut Creek CA 94596-5318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases, which is considered as his primary health care specialty. Bergen, Randy E. can be contacted via phone (925) 295-4000.

Contact Information

Primary practice address
1425 S Main St Walnut Creek CA 94596-5318
Phone: (925) 295-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X G52916 California

Profile Details

NPI number 1316025497
LBN Legal business name Bergen, Randy E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316025497 NPPES
California MEDICAID 00G529160

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