| Jeffrey A Berenson Md A Professional Corporation | |
|
45081 Little Lake Street Mendocino CA 95460 | |
| (707) 937-1055 | |
| (707) 937-1061 |
| Full Name | Jeffrey A Berenson Md A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 45081 Little Lake Street, Mendocino, California |
| Authorized Official Name and Position | Jeffrey A Berenson (CEO OWNER) |
| Authorized Official Contact | 7079371055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey A Berenson Md A Professional Corporation Po Box 38 Mendocino CA 95460 Ph: (707) 937-1055 | Jeffrey A Berenson Md A Professional Corporation 45081 Little Lake Street Mendocino CA 95460 Ph: (707) 937-1055 |
| NPI Number | 1881625671 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 04/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881625671 | NPI | - | NPPES |
| 00G395740 | Other | CA | BLUE CROSS |
| 00G395740 | Other | CA | BLUE SHIELD |
| 00G395740 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45081 Little Lake St, Mendocino, CA 95460 Phone: 707-573-6166 Fax: 707-573-6165 |