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General NPI Number Information
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NPI Number | 1821428210
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Entity Type | Individual
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Provider Name | PAMELA TRAINER BERRY
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Gender | Female
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Dates
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Enumeration Date | 11/20/2013
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Last Update Date | 11/20/2013
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Provider Practice Location Address
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Address Line | 1500 S SUNKIST ST SUITE D
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City | ANAHEIM
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State | CA
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Zip | 92806-5815
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Country | US
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Telephone | 657-888-6250
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Fax | 657-888-6251
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Provider Business Mailing Address
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Address Line | 8 PACIFIC CRST
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-5316
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Country | US
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Telephone | 714-580-4634
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Fax | 657-888-6251
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | CPO01856
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License Number State | CA
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