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Organization
MICHAEL K BERRY MD A PROFESSIONAL CORPORATION
Active
Organization
MICHAEL K BERRY MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL K BERRY M.D. (PRESIDENT)
(480) 967-6500
Entity
Organization
Contact information
Practice address
250 PROSPECT PL, CORONADO, CA 92118-1943
(619) 522-3722
Mailing address
PO BOX 28247, TEMPE, AZ 85285-8247
(480) 967-6500
(480) 967-6540
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G072558
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G725580
—
CA
Enumeration date
01/10/2007
Last updated
09/28/2010
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