Individual
JAMES DOUGLAS BERGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1794
(855) 489-4580
Mailing address
144 HOLM RD SPC 31, WATSONVILLE, CA 95076-2427
(831) 277-0810
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
049011
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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