Healthcare Provider Details

I. General information

NPI: 1679595698
Provider Name (Legal Business Name): DAVID A BERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 EL CAMINO REAL STE 100
LOS ALTOS CA
94022-1090
US

IV. Provider business mailing address

4300 EL CAMINO REAL STE 100
LOS ALTOS CA
94022-1090
US

V. Phone/Fax

Practice location:
  • Phone: 650-325-6000
  • Fax: 650-325-8091
Mailing address:
  • Phone: 650-325-6000
  • Fax: 650-325-8091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA49482
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: