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General NPI Number Information
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NPI Number | 1053701540
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Entity Type | Individual
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Provider Name | PHILIP L BERGER BPHARM
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Gender | Male
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 30495 CANWOOD ST
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4331
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Country | US
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Telephone | 818-532-7150
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 940896
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City | SIMI VALLEY
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State | CA
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Zip | 93094-0896
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH46908
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License Number State | CA
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