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NPI Code Detail

MEDICARE: MICHAEL K BERRY M.D.

MEDICARE: MICHAEL K BERRY M.D.
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
1207P00000XEmergency Medicine PhysicianG72558CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861494569
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL K BERRY M.D.
Provider Business Mailing Address
First Line : PO BOX 12439
Second Line :
City : WESTMINSTER
State : CA
Zip : 92685-2439
Country : US
Telephone Number : 562-468-0227
Fax Number :
Provider Business Practice Location Address
First Line : 1415 ROSS AVE
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-4306
Country : US
Telephone Number : 760-339-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 02/10/2009

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Directions to “ MICHAEL K BERRY M.D.” Practice Location

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