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General NPI Number Information
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NPI Number | 1356814453
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Entity Type | Organization
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Legal Business Name | REGINA BERKOVICH MD PHD INC
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 8727 BEVERLY BLVD STE B
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1803
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Country | US
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Telephone | 310-474-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 8727 BEVERLY BLVD STE B
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1803
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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 | OWNER
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Name | REGINA BERKOVICH
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Credential | MD
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Telephone | 818-331-9136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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