Individual
DR. THOMAS M BERGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3131 LA CANADA ST STE 200, LAS VEGAS, NV 89169-2579
(702) 369-5582
(702) 650-5148
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101023688
MI
207R00000X
Internal Medicine Physician
Primary
DO2846
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770094153
—
NV
01
—
DO2846
STATE LICENSE
NV
Enumeration date
10/12/2017
Last updated
08/17/2023
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