Healthcare Provider Details
I. General information
NPI: 1952980369
Provider Name (Legal Business Name): CHRISTIAN ALLEN BERGMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/04/2021
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6200 N LA CHOLLA BLVD
TUCSON AZ
85741-3529
US
IV. Provider business mailing address
650 STEWART AVE
COLUMBUS OH
43206-2974
US
V. Phone/Fax
- Phone: 520-742-9000
- Fax:
- Phone: 707-980-1315
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171000000X |
| Taxonomy | Military Health Care Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 76588 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: