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General NPI Number Information
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NPI Number | 1871972083
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Entity Type | Organization
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Legal Business Name | GREGORY M. BERKOFF D.C., INC., DOCTOR OF CHIROPRACTIC, A PROF CORP.
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 07/22/2024
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Provider Practice Location Address
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Address Line | 8950 VILLA LA JOLLA DR STE C129
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City | LA JOLLA
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State | CA
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Zip | 92037-1707
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Country | US
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Telephone | 858-622-9459
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Fax | 858-622-9458
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Provider Business Mailing Address
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Address Line | 4520 EXECUTIVE DR SUITE 105
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City | SAN DIEGO
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State | CA
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Zip | 92121-3018
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Country | US
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Telephone | 858-622-9459
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Fax | 858-622-9458
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. TRICIA M. BERKOFF
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Credential | D.C.
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Telephone | 858-999-5153
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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 | 19710
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License Number State | CA
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