Individual
PHILLIP J BERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLZ, LOS ANGELES, CA 90095-0001
(310) 825-0128
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5631
(310) 825-0128
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G81089
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G810890
—
CA
Enumeration date
12/01/2005
Last updated
04/15/2010
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