Mr Berman Ivan Icabalceta Jr, is a
Specialist based in San Bruno, California. Mr Berman Ivan Icabalceta Jr is licensed to practice in * (Not Available) (license number ) and his current practice location is
1001 Sneath Ln Ste 307, San Bruno, California. He can be reached at his office (for appointments etc.) via phone at
(650) 244-0305.
NPI number for Mr Berman Ivan Icabalceta Jr is 1659763282 and his current mailing address is 301 Grand Ave, Suite 301, South San Francisco, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1659763282.
Healthcare Provider's Profile
| Full Name | Mr Berman Ivan Icabalceta Jr |
|---|
| Gender | Male |
|---|
| Speciality | Specialist |
|---|
| Location | 1001 Sneath Ln Ste 307, San Bruno, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1659763282
- Provider Enumeration Date: 02/18/2015
- Last Update Date: 06/14/2019
Medical Identifiers
Medical identifiers for Mr Berman Ivan Icabalceta Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659763282 | NPI | - | NPPES |
| 38472 | Other | CA | THE LATINO COMMISSION ADMINISTRATION |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Berman Ivan Icabalceta Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Berman Ivan Icabalceta Jr,
301 Grand Ave, Suite 301,
South San Francisco, CA 94080-3606
Ph: (650) 244-0305 | Mr Berman Ivan Icabalceta Jr,
1001 Sneath Ln Ste 307,
San Bruno, CA 94066
Ph: (650) 244-0305 |
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