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General NPI Number Information
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NPI Number | 1033406574
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Entity Type | Individual
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Provider Name | SAGIR GIRISH BERA D.O., M.P.H., M.S.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2011
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Last Update Date | 11/01/2019
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Provider Practice Location Address
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Address Line | 4323 W RIVERSIDE DR
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City | BURBANK
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State | CA
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Zip | 91505-4044
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Country | US
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Telephone | 818-556-2700
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Fax | 818-295-3450
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD SUITE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-301-8732
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Fax | 310-301-8751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 20A13747
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A13747
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License Number State | CA
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