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NPI Code Detail

MEDICARE: JACK BERGAL DO

MEDICARE: JACK BERGAL DO
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
1208M00000XHospitalist Physician20A20526CA

General Provider Information

NPI Number : 1629693858
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK BERGAL DO
Provider Business Mailing Address
First Line : PO BOX 276004
Second Line :
City : SACRAMENTO
State : CA
Zip : 95827-6004
Country : US
Telephone Number : 800-478-8837
Fax Number : 916-739-3623
Provider Business Practice Location Address
First Line : 317 W PUEBLO ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-4310
Country : US
Telephone Number : 805-898-3077
Fax Number : 805-898-3058
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2020
Last Update Date : 02/09/2026

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Directions to “ JACK BERGAL DO” Practice Location

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