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DR. JOHN D BERGREN MD

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1023110301

Individual Registrant:
DR. JOHN D BERGREN MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
13350 BIG BASIN WAY  BOULDER CREEK, CA 95006-9237 US
Tel: 831-338-6491  Fax: 931-338-2767

Contact information for business:
3400 DATA DR  RANCHO CORDOVA, CA 95670-7956 US
Tel: 916-379-2915  Fax: --

Registration Information:
NPI: 1023110301
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CAG79510
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AK4035

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MD0772AK05




HEALTH CARE JOBS CA - Page 1



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