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General NPI Number Information
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NPI Number | 1063236313
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Entity Type | Organization
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Legal Business Name | THE DNA COMPANY
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 650 E PARKRIDGE AVE STE 109
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City | CORONA
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State | CA
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Zip | 92879-1092
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Country | US
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Telephone | 866-552-7652
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Fax | 714-908-8200
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Provider Business Mailing Address
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Address Line | 650 E PARKRIDGE AVE STE 109
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City | CORONA
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State | CA
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Zip | 92879-1092
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Country | US
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Telephone | 866-552-7652
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Fax | 714-908-8200
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Authorized Official
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Title or Position | CMO
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Name | DR. BOYCE BERKEL
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Credential | MD
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Telephone | 727-505-5987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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