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General NPI Number Information
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NPI Number | 1093993248
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Entity Type | Organization
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Legal Business Name | ALI REZA BERENJI M D A PROF CORP
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 500 E ESPLANADE DR SUITE 815
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City | OXNARD
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State | CA
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Zip | 93036-0540
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Country | US
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Telephone | 805-983-7578
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Fax | 805-981-8346
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Provider Business Mailing Address
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Address Line | PO BOX 6126
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City | OXNARD
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State | CA
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Zip | 93031-6126
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Country | US
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Telephone | 805-983-7578
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Fax | 805-981-8346
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALI REZA BERENJI
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Credential | M.D.
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Telephone | 805-983-7578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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