Healthcare Provider Details

I. General information

NPI: 1215976659
Provider Name (Legal Business Name): L'ABBE AND BERKENFIELD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PALM AVE SUITE 108A
IMPERIAL BEACH CA
91932-1200
US

IV. Provider business mailing address

600 PALM AVE SUITE 108A
IMPERIAL BEACH CA
91932-1200
US

V. Phone/Fax

Practice location:
  • Phone: 619-575-7170
  • Fax: 619-575-7192
Mailing address:
  • Phone: 619-575-7170
  • Fax: 619-575-7192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JULES A BERKENFIELD
Title or Position: M.D.
Credential: M.D.
Phone: 619-575-7170