MEDICARE: BERRYMAN HEALTH INC.

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	314000000X	Skilled Nursing Facility		CA

General Provider Information

NPI Number	:	1518909035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERRYMAN HEALTH INC.

Provider Business Mailing Address
First Line	:	PO BOX 5969
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-5969
Country	:	US
Telephone Number	:	714-272-9358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1973 N GLACIER ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-2459
Country	:	US
Telephone Number	:	714-272-9358
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN A ALAUX
Credential	:
Telephone Number	:	714-272-9358

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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