Provider Demographics
NPI:1619102191
Name:BERKOVIC, YURO J (MD)
Entity type:Individual
Prefix:
First Name:YURO
Middle Name:J
Last Name:BERKOVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JURAJ
Other - Middle Name:
Other - Last Name:BERKOVIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3660 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3987
Mailing Address - Country:US
Mailing Address - Phone:951-782-3050
Mailing Address - Fax:
Practice Address - Street 1:7117 BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2658
Practice Address - Country:US
Practice Address - Phone:951-782-3830
Practice Address - Fax:951-784-5568
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27218207Y00000X
LAGETP.201076390200000X
CAA161452207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program