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General NPI Number Information
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NPI Number | 1780815464
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Entity Type | Organization
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Legal Business Name | DESERT SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 16222 N 59TH AVE A-100
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City | GLENDALE
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State | AZ
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Zip | 85306-1701
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Country | US
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Telephone | 623-334-4000
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Fax | 623-334-4400
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Provider Business Mailing Address
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Address Line | 16222 N 59TH AVE A-100
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City | GLENDALE
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State | AZ
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Zip | 85306-1701
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Country | US
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Telephone | 623-334-4000
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Fax | 623-334-4400
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID F BERG
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Credential | D.C.
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Telephone | 623-334-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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