Individual provider Active NPI

Melba Agatep Berbano, MD

  • Obstetrics & Gynecology Physician
  • Stockton, CA
National Provider Identifier
1013002716
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A053064 Issued in CA
Practice address
1801 E March LN Ste C320
Stockton, CA 95210-6676
Phone
(209) 957-5888
Fax
(209) 477-9339
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A053064 CA Primary

Addresses

Primary practice location

1801 E March LN Ste C320
Stockton, CA 95210-6676

Mailing address

1801 E March LN Ste C320
Stockton, CA 95210-6676
Phone (209) 957-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070601000284 CA Practitioner - Obstetrics/Gynecology 1951409762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A053064CAMDObstetrics & Gynecology Physician

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1013002716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE C320",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106676",
            "telephone_number": "209-957-5888",
            "fax_number": "209-477-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN STE C320",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106676",
            "telephone_number": "209-957-5888",
            "fax_number": "209-477-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERBANO",
        "first_name": "MELBA",
        "middle_name": "AGATEP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A053064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.