Provider Demographics
NPI:1538350392
Name:AMIR BERJIS MD INC
Entity type:Organization
Organization Name:AMIR BERJIS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BERJIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-663-7007
Mailing Address - Street 1:9900 STOCKDALE HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3632
Mailing Address - Country:US
Mailing Address - Phone:661-663-7007
Mailing Address - Fax:661-664-9989
Practice Address - Street 1:9900 STOCKDALE HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3632
Practice Address - Country:US
Practice Address - Phone:661-663-7007
Practice Address - Fax:661-664-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75137208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A751371Medicaid
CAZZZ05378ZMedicare PIN