1881603074 NPI number — DR. ROSS ALBERT BERLINER DPM

Table of content: MRS. YVETTE FIGUEROA NP (NPI 1679586630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881603074 NPI number — DR. ROSS ALBERT BERLINER DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERLINER
Provider First Name:
ROSS
Provider Middle Name:
ALBERT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881603074
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3545 GRIFFITH PARK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90027-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-664-4331
Provider Business Mailing Address Fax Number:
323-664-4331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1417 W BEVERLY BLVD
Provider Second Line Business Practice Location Address:
104
Provider Business Practice Location Address City Name:
MONTEBELLO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90640-4123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-721-6026
Provider Business Practice Location Address Fax Number:
323-887-1891
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  E3948 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000E39480 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: W12208A . This is a "MEDICARE ID ARCADIA" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GRE001100 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: GRE000311 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00171944 . This is a "RAILROAD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: W10901 . This is a "NARBONNE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 000E39482 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: GR0049330 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: WE3948G . This is a "MEDICARE PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GRE000310 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: DA3847 . This is a "RAILROAD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: P00016205 . This is a "RAILROAD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: GR0047500 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: W11318 . This is a "AVALON" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: W12208 . This is a "MEDICARE ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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