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General NPI Number Information
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NPI Number | 1760697858
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Entity Type | Individual
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Provider Name | ADRIANE BERGMAN PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8730 SANTA MONICA BLVD STE G
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4547
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Country | US
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Telephone | 310-659-2740
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Fax | 310-659-2748
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Provider Business Mailing Address
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Address Line | 10262 MONTE MAR DR
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City | LOS ANGELES
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State | CA
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Zip | 90064-3430
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Country | US
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Telephone | 310-839-4997
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 16399
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License Number State | CA
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