Healthcare Provider Details

I. General information

NPI: 1972864387
Provider Name (Legal Business Name): ARDIN SUI BERGER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 REGENT ST STE 522
BERKELEY CA
94705-2120
US

IV. Provider business mailing address

2999 REGENT ST STE 522
BERKELEY CA
94705-2120
US

V. Phone/Fax

Practice location:
  • Phone: 650-313-1523
  • Fax:
Mailing address:
  • Phone: 510-575-9409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number20A16103
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A16103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: