Healthcare Provider Details

I. General information

NPI: 1548751548
Provider Name (Legal Business Name): ADRIAN BERCI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 LEVENDI LN
SACRAMENTO CA
95821-2242
US

IV. Provider business mailing address

4107 LEVENDI LN
SACRAMENTO CA
95821-2242
US

V. Phone/Fax

Practice location:
  • Phone: 916-628-2022
  • Fax:
Mailing address:
  • Phone: 916-628-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: