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General NPI Number Information
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NPI Number | 1417112939
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Entity Type | Organization
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Legal Business Name | BRETT J. BERMAN, M.D., PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 06/26/2019
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Provider Practice Location Address
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Address Line | 321 E ST STE A
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City | CHULA VISTA
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State | CA
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Zip | 91910-2667
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Country | US
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Telephone | 619-934-3260
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 120847
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City | CHULA VISTA
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State | CA
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Zip | 91912-4447
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Country | US
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Telephone | 858-450-1246
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Fax | 858-453-9271
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRETT J. BERMAN
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Credential | M.D.
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Telephone | 858-450-1246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A78854
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License Number State | CA
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