Healthcare Provider Details

I. General information

NPI: 1942795380
Provider Name (Legal Business Name): DINA BIERMAN, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSPITAL RD STE 209
NEWPORT BEACH CA
92663-3504
US

IV. Provider business mailing address

PO BOX 1052
PACIFIC PALISADES CA
90272-1052
US

V. Phone/Fax

Practice location:
  • Phone: 949-646-3333
  • Fax: 949-646-3334
Mailing address:
  • Phone: 714-287-5284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA124111
License Number StateCA

VIII. Authorized Official

Name: DR. DINA FARSHIDI BIERMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 714-287-5284