Organization Name: | STEPHEN C BERENS, MD A MED. CORP. |
NPI Number: | 1992850879 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERTA J BERENS (VICE PRE & SEC. OF CORPORATION) |
Mailing Address: | 1301 20th St. Suite 590 Santa Monica |
State: | CA US |
Postal Code: | 90404 |
Phone Number: | 3108284633 |
Fax Number: | 8187845639 |
NPI Enumeration Date: | 01/24/2007 |
NPI Last Update Date: | 06/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A22556 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |