Organization
KWB MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN BERGER MD (OWNER)
(818) 858-0211
Entity
Organization
Contact information
Practice address
7537 LAUREL CANYON BLVD UNIT A, N HOLLYWOOD, CA 91605-3149
(818) 858-0211
Mailing address
7537 LAUREL CANYON BLVD UNIT A, N HOLLYWOOD, CA 91605-3149
(818) 858-0211
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C53406
MEDICAL LICENSE
CA
Enumeration date
01/31/2022
Last updated
01/31/2022
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