Healthcare Provider Details

I. General information

NPI: 1619102191
Provider Name (Legal Business Name): YURO J BERKOVIC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JURAJ BERKOVIC

II. Dates (important events)

Enumeration Date: 05/27/2009
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

3660 ARLINGTON AVE
RIVERSIDE CA
92506-3987
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-6049
  • Fax: 818-847-4842
Mailing address:
  • Phone: 951-782-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberA161452
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberGETP.201076
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number27218
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: