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Individual
JEFFREY ALAN BERENSON
Active
Individual
JEFFREY ALAN BERENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G39574
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G395740
BLUE SHIELD
CA
05
—
1902828619
—
CA
01
—
P00872335
RAILROAD MEDICARE
CA
Enumeration date
07/24/2006
Last updated
03/25/2021
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