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NPI Code Detail

MEDICARE: DR. JENNIFER ANN BERUMEN M.D

MEDICARE: DR. JENNIFER ANN BERUMEN 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
1208600000XSurgery PhysicianA106782CA

General Provider Information

NPI Number : 1558566372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ANN BERUMEN M.D
Provider Business Mailing Address
First Line : PO BOX 232410
Second Line :
City : SAN DIEGO
State : CA
Zip : 92193-2410
Country : US
Telephone Number : 858-249-6748
Fax Number : 619-543-3183
Provider Business Practice Location Address
First Line : 200 W ARBOR DR
Second Line : MC 8401
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number : 619-543-5870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2007
Last Update Date : 05/04/2017

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