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NPI Code Detail

MEDICARE: MARA GABHRIEL BERMAN D.P.T.

MEDICARE: MARA GABHRIEL BERMAN D.P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist35906CA

General Provider Information

NPI Number : 1073745972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARA GABHRIEL BERMAN D.P.T.
Provider Business Mailing Address
First Line : 100 OCEANO AVE APT 26
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93109-2228
Country : US
Telephone Number : 805-453-0581
Fax Number :
Provider Business Practice Location Address
First Line : 2921 DE LA VINA ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3309
Country : US
Telephone Number : 805-898-1907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2009
Last Update Date : 08/11/2009

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