Berman, Jack
Berman, Jack is an individual health care provider with primary practice located at 2428 Santa Monica Blvd , Santa Monica CA 90404-2045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Berman, Jack can be contacted via phone (310) 315-1000.Contact Information
Primary practice address
2428 Santa Monica Blvd
Santa Monica CA 90404-2045
Phone: (310) 315-1000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | C33328 | California |
Profile Details
NPI number | 1417977786 |
---|---|
LBN Legal business name | Berman, Jack |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 20th, 2006 |
Last updated | Aug 8th, 2022 - about 3 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 | 1417977786 | NPPES |
California | MEDICAID | 00C333280 | |
California | Other | 00C333280 |
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