Healthcare Provider Details

I. General information

NPI: 1942336417
Provider Name (Legal Business Name): DANIEL N BEREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 EUREKA DR
STUDIO CITY CA
91604-3106
US

IV. Provider business mailing address

3844 EUREKA DR
STUDIO CITY CA
91604-3106
US

V. Phone/Fax

Practice location:
  • Phone: 818-985-9202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAFE 19310
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: