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:
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Health care specialties

SpecialtyCodeLicense #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 2 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 1417977786 NPPES
California MEDICAID 00C333280
California Other 00C333280

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