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General NPI Number Information
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NPI Number | 1699738229
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Entity Type | Individual
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Provider Name | CHRISTOPHER J BERG PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 12/30/2022
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Provider Practice Location Address
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Address Line | 2350 MIRACLE MILE # 600A
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City | BULLHEAD CITY
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State | AZ
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Zip | 86442-7505
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Country | US
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Telephone | 928-758-9362
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Fax |
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Provider Business Mailing Address
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Address Line | 9097 W POST RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89148-2417
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Country | US
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Telephone | 702-430-5333
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00739
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8338
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License Number State | AZ
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