Individual
JAAFAR BERMANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
129 N 8TH ST, EAST ST LOUIS, IL 62201
(618) 482-7242
(314) 810-1399
Mailing address
14351 CLARISSA LN, TUSTIN, CA 92780-2211
(714) 731-2030
(714) 731-3624
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A29471
CA
208600000X
Surgery Physician
Primary
036052408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052408
—
IL
Enumeration date
06/13/2005
Last updated
06/08/2018
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