Organization Active NPI

John a Berger M.D. a Professional Corporation

  • Family Medicine Physician
  • San Diego, CA
National Provider Identifier
1295919157
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G16367 Issued in CA
Legal business name
JOHN A BERGER M.D. A PROFESSIONAL CORPORATION
Practice address
205 Walnut Ave
San Diego, CA 92103-4903
Phone
(619) 295-2147
Fax
(619) 295-2328
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Dr. John A Berger, M.D.
Title
President
Phone
(619) 295-2147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G16367 CA Primary

Addresses

Primary practice location

205 Walnut Ave
San Diego, CA 92103-4903

Mailing address

205 Walnut Ave
San Diego, CA 92103-4903
Phone (619) 295-2147

Other identifiers 1

IdentifierTypeStateIssuer
00G163670MedicaidCA

National Provider Directory

National Provider Directory

Locations

205 Walnut Ave
San Diego, CA 92103
Phone (619) 295-2147

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1295919157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034903",
            "telephone_number": "619-295-2147",
            "fax_number": "619-295-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WALNUT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034903",
            "telephone_number": "619-295-2147",
            "fax_number": "619-295-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN A BERGER M.D. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-295-2147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G16367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G163670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.