Provider Demographics
NPI:1215959077
Name:BERMAN, MADHU (MD)
Entity type:Individual
Prefix:
First Name:MADHU
Middle Name:
Last Name:BERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MADHU
Other - Middle Name:
Other - Last Name:NAIDU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:29000 WESTERN AVE
Mailing Address - Street 2:STE NO 200
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275
Mailing Address - Country:US
Mailing Address - Phone:310-833-1334
Mailing Address - Fax:310-833-0270
Practice Address - Street 1:29000 WESTERN AVE
Practice Address - Street 2:STE #200
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275
Practice Address - Country:US
Practice Address - Phone:310-833-1334
Practice Address - Fax:310-833-0270
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA47762207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F14664Medicare UPIN
A47762Medicare ID - Type Unspecified