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Individual
PAUL S. BERRY
Active
Individual
PAUL S. BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G72073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G720730
MEDI-CAL
CA
01
—
G72073
STAE LICENSE PHYSICIAN
CA
Enumeration date
10/28/2005
Last updated
07/13/2026
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