Bergen, Ronnie
Bergen, Ronnie is an individual health care provider with primary practice located at 300 Medical Plaza #B200 , Los Angeles CA 90095-6204. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as her primary health care specialty. Bergen, Ronnie can be contacted via phone (310) 794-1195.Contact Information
Primary practice address
300 Medical Plaza #B200
Los Angeles CA 90095-6204
Phone: (310) 794-1195
Fax: (310) 794-7491
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | G146479 | California |
Profile Details
NPI number | 1750353488 |
---|---|
LBN Legal business name | Bergen, Ronnie |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 6th, 2006 |
Last updated | Jan 15th, 2020 - about 4 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1750353488 | NPPES |
Arizona | Other | 130008650 | RR MEDICARE |
Arizona | Other | ZWCGCR | RR MEDICARE |
Arizona | MEDICAID | 073841 | RR MEDICARE |
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