Healthcare Provider Details

I. General information

NPI: 1477956563
Provider Name (Legal Business Name): CHRISTOPHER M BERO PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 01/20/2024
Certification Date: 01/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8575 E PRINCESS DR STE 210
SCOTTSDALE AZ
85255-5441
US

IV. Provider business mailing address

11 SPUR CIR
SCOTTSDALE AZ
85251-5460
US

V. Phone/Fax

Practice location:
  • Phone: 480-808-3778
  • Fax: 480-409-5204
Mailing address:
  • Phone: 480-216-1616
  • Fax: 480-372-2110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5861
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5861
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number5861
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: