Joel a Berman, MD Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

G24685 Issued in CA

Legal business name

JOEL A BERMAN, MD INC

Practice address

11100 Warner Ave
Suite 108
Fountain Valley, CA 92708-7506

Phone

(714) 979-3201

Fax

(714) 979-1406

NPI assigned

Jul 16, 2007

Last updated

Jul 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joel A Berman, M.D.NPI 1790724490

Title

President

Phone

(714) 979-3201

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joel A Berman, M.D.

  • Surgery Physician
  • Fountain Valley, CA
  • NPI 1790724490
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1487853792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 108",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-3201",
            "fax_number": "714-979-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 108",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-979-3201",
            "fax_number": "714-979-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL A BERMAN, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-979-3201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G24685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G246851",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexander Johnson, PPS SCHOOL COUNSELOR
• Destiny B Johnson
• Karlyn Johnson
• Jonathan L Tong, M.D., Corporation

• Surgery Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.