MEDICARE: DR. RABIN BERAL DPM

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
1	213E00000X	Podiatrist	E4528	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E4528	OTHER	CA	BD OF PODIATRIC MEDICINE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	5185000001	OTHER	CA	DMERC

General Provider Information

NPI Number	:	1154361871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RABIN BERAL DPM

Provider Business Mailing Address
First Line	:	3521 LOMITA BLVD STE 103
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90505-5041
Country	:	US
Telephone Number	:	310-534-9131
Fax Number	:	310-534-9132

Provider Business Practice Location Address
First Line	:	1141 W REDONDO BEACH BLVD STE 206
Second Line	:
City	:	GARDENA
State	:	CA
Zip	:	90247-3584
Country	:	US
Telephone Number	:	310-515-8155
Fax Number	:	310-515-8833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	08/30/2023

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