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General NPI Number Information
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NPI Number | 1942295381
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Entity Type | Individual
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Provider Name | BRENDA BERRY MD
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Gender | Female
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 1290 E SPRUCE AVE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93720-3371
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Country | US
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Telephone | 559-431-2397
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 E SPRUCE AVE STE 101
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City | FRESNO
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State | CA
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Zip | 93720-3371
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Country | US
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Telephone | 559-323-2145
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G85561
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License Number State | CA
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