Healthcare Provider Details

I. General information

NPI: 1235388828
Provider Name (Legal Business Name): SUZANNE LAUREN BERKMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUZANNE LAUREN MEYER M.D.

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 06/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD SUITE 545
BEVERLY HILLS CA
90211-2007
US

IV. Provider business mailing address

8920 WILSHIRE BLVD SUITE 545
BEVERLY HILLS CA
90211-2007
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-3003
  • Fax: 310-854-0811
Mailing address:
  • Phone: 310-854-3003
  • Fax: 310-854-0811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberA124089
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD037491
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: