MEDICARE: DAVID B BERGMAN MD

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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1649357682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID B BERGMAN MD

Provider Business Mailing Address
First Line	:	7373 UNIVERSITY AVE
Second Line	:	213
City	:	LA MESA
State	:	CA
Zip	:	91941-6000
Country	:	US
Telephone Number	:	858-292-2929
Fax Number	:

Provider Business Practice Location Address
First Line	:	3750 CONVOY ST
Second Line	:	318
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-3738
Country	:	US
Telephone Number	:	858-292-2929
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID B BERGMAN
Credential	:	MD
Telephone Number	:	858-292-2929

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	02/19/2008

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