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NPI Code Detail

MEDICARE: BRIAN BERGERON N.P.

MEDICARE: BRIAN BERGERON N.P.
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
1363L00000XNurse PractitionerRN2275289MA
2363LA2100XAcute Care Nurse Practitioner95037713CA

General Provider Information

NPI Number : 1306239660
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN BERGERON N.P.
Provider Business Mailing Address
First Line : 4140 W 190TH ST
Second Line :
City : TORRANCE
State : CA
Zip : 90504-5513
Country : US
Telephone Number : 310-423-3851
Fax Number : 310-423-3522
Provider Business Practice Location Address
First Line : 127 S SAN VICENTE BLVD STE A3600
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-3311
Country : US
Telephone Number : 310-423-3851
Fax Number : 310-423-3522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2015
Last Update Date : 01/26/2026

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Directions to “ BRIAN BERGERON N.P.” Practice Location

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