Healthcare Provider Details

I. General information

NPI: 1548707326
Provider Name (Legal Business Name): CERBO CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N 14TH ST STE 650
SAN JOSE CA
95112-6213
US

IV. Provider business mailing address

555 BRYANT ST STE 909
PALO ALTO CA
94301-1704
US

V. Phone/Fax

Practice location:
  • Phone: 650-250-5056
  • Fax:
Mailing address:
  • Phone: 650-257-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number72823
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number72823
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number72823
License Number StateCA

VIII. Authorized Official

Name: SOREN A SINGEL
Title or Position: CEO
Credential: DR. MED.
Phone: 650-257-2976