Individual
BERGEN ELIZABETH FOLSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3003 HEALTH CENTER DRIVE, SAN DIEGO, CA 92123
(858) 939-4198
(858) 939-4972
Mailing address
8555 AERO DRIVE, SUITE 104, SAN DIEGO, CA 92123
(858) 939-4198
(858) 939-4972
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A88203
CA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
A88203
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A901670
—
CA
Enumeration date
10/03/2006
Last updated
07/24/2019
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