MEDICARE: DR. MYRON TZALEL BERDISCHEWSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	G34045	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G34045	OTHER	CA	MEDICAL BOARD OF CA

General Provider Information

NPI Number	:	1013068931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRON TZALEL BERDISCHEWSKY M.D.

Provider Business Mailing Address
First Line	:	14301 MILLBROOK DR
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-4426
Country	:	US
Telephone Number	:	818-907-6103
Fax Number	:

Provider Business Practice Location Address
First Line	:	12215 VENTURA BLVD
Second Line	:	SUITE 106
City	:	STUDIO CITY
State	:	CA
Zip	:	91604-2533
Country	:	US
Telephone Number	:	818-769-2247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	03/07/2023

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