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KRISTIN C BERGSTROM MD

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1679568711

Individual Registrant:
 KRISTIN C BERGSTROM MD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1992 OLD MISSION DR STE 140  SOLVANG, CA 93463-2302 US
Tel: 805-614-5690  Fax: --

Contact information for business:
1702 UNIVERSITY DR S  FARGO, ND 58103-4940 US
Tel: --  Fax: --

Registration Information:
NPI: 1679568711
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
MN32101
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
CAG168185

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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