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General NPI Number Information
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NPI Number | 1962415224
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Entity Type | Individual
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Provider Name | MAINA V BERGER M.D
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD SUITE 420
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City | LOS ANGELES
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State | CA
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Zip | 90036-4667
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Country | US
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Telephone | 323-525-1111
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Fax | 323-525-1100
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Provider Business Mailing Address
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Address Line | 5901 W OLYMPIC BLVD SUITE 420
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City | LOS ANGELES
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State | CA
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Zip | 90036-4667
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Country | US
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Telephone | 323-525-1111
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Fax | 323-525-1100
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A43473
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License Number State | CA
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