Individual
GARY ROBERT BERGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
907 PICO BLVD, SANTA MONICA, CA 90405
(310) 314-6200
Mailing address
1114 SAN VICENTE BLVD APT B, SANTA MONICA, CA 90402-2008
(310) 663-2336
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN218892
CA
Other
Enumeration date
11/17/2008
Last updated
10/02/2019
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