Organization
ROGER BERTOLDI MD PROFESSIONAL CORPORATION
Active
Organization
ROGER BERTOLDI MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER V BERTOLDI MD (PHYSICIAN/OWNER)
(310) 670-5555
Entity
Organization
Contact information
Practice address
8610 S. SEPULVEDA BLVD., LOS ANGELES, CA 90045
(310) 670-5555
(310) 670-9222
Mailing address
8610 S. SEPULVEDA BLVD., SUITE 200, LOS ANGELES, CA 90045
(310) 670-5555
(310) 670-9222
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
A40519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008405191
—
CA
Enumeration date
05/11/2010
Last updated
03/19/2015
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