Individual
DR. MICAH DIAZ BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
710 MIRA MONTE PL, PASADENA, CA 91101-2521
(310) 569-5933
Mailing address
300 SIERRA COLLEGE DR, STE 250, GRASS VALLEY, CA 95945-5083
(530) 477-0011
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A110714
CA
Other
Enumeration date
06/23/2009
Last updated
02/01/2021
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