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NPI Code Detail

MEDICARE: DR. BEHRAM R SOONAWALA M.D.

MEDICARE: DR. BEHRAM R SOONAWALA M.D.
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
1207R00000XInternal Medicine PhysicianA64516CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104895085
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BEHRAM R SOONAWALA M.D.
Provider Business Mailing Address
First Line : 1510 4TH ST
Second Line : SUITE 1
City : BERKELEY
State : CA
Zip : 94710-1717
Country : US
Telephone Number : 510-525-8980
Fax Number :
Provider Business Practice Location Address
First Line : 1510 4TH ST
Second Line : SUITE 1
City : BERKELEY
State : CA
Zip : 94710-1717
Country : US
Telephone Number : 510-525-8980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/09/2008

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