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Individual

JUDY S. BERTELSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2401 BLANDING AVE, ALAMEDA, CA 94501-1503
(510) 486-1467
Mailing address
PO BOX 2774, BERKELEY, CA 94702-0774
(510) 486-1467

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
G79823
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G798230
CA
Enumeration date
01/18/2007
Last updated
01/16/2009
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