Healthcare Provider Details

I. General information

NPI: 1144136144
Provider Name (Legal Business Name): ZACHARY WILLIAM BERLEHNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4170 NORMAN SCOTT RD STE 5
SAN DIEGO CA
92136-5521
US

IV. Provider business mailing address

3255 5TH AVE APT 317
SAN DIEGO CA
91203
US

V. Phone/Fax

Practice location:
  • Phone: 619-767-6573
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: