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Organization
JOSE D BERGANZA, M.D INC
Active
Organization
JOSE D BERGANZA, M.D INC
Active
Other names
SAN JOSE MUILTISPECIALTY MEDICAL GROUP,INC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE DALIO BERGANZA M.D (PRESIDENT)
(626) 337-0424
Entity
Organization
Contact information
Practice address
14514 RAMONA BLVD, SUITE 3, BALDWIN PARK, CA 91706-3305
(626) 337-0424
(626) 813-9095
Mailing address
14514 RAMONA BLVD, SUITE 3, BALDWIN PARK, CA 91706-3305
(626) 337-0424
(626) 813-9095
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A055611
CA
207V00000X
Obstetrics & Gynecology Physician
524415
CA
207V00000X
Obstetrics & Gynecology Physician
557547
CA
207V00000X
Obstetrics & Gynecology Physician
A37324
CA
208000000X
Pediatrics Physician
A45608
CA
208000000X
Pediatrics Physician
PA12379
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0080790
—
CA
Enumeration date
12/04/2006
Last updated
01/09/2008
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