Provider Demographics
NPI:1063236313
Name:THE DNA COMPANY
Entity type:Organization
Organization Name:THE DNA COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:BOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-505-5987
Mailing Address - Street 1:650 E PARKRIDGE AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1092
Mailing Address - Country:US
Mailing Address - Phone:866-552-7652
Mailing Address - Fax:714-908-8200
Practice Address - Street 1:650 E PARKRIDGE AVE STE 109
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1092
Practice Address - Country:US
Practice Address - Phone:866-552-7652
Practice Address - Fax:714-908-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty