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Individual

BENTE H BERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
29525 CANWOOD ST, SUITE 219, AGOURA HILLS, CA 91301-4233
(818) 865-8133
(818) 865-1223
Mailing address
29525 CANWOOD ST, SUITE 219, AGOURA HILLS, CA 91301-4233
(818) 865-8133
(818) 865-1223

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G57381
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95-4397431
TAX ID #
CA
01
G57381
LICENSE #
CA
Enumeration date
11/01/2006
Last updated
07/09/2007
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