Provider Demographics
NPI:1730250416
Name:DARYL BERMAN, PROFESSIONAL CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:DARYL BERMAN, PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-538-4414
Mailing Address - Street 1:1303 A ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-2928
Mailing Address - Country:US
Mailing Address - Phone:510-538-4414
Mailing Address - Fax:510-889-1149
Practice Address - Street 1:1303 A ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-2928
Practice Address - Country:US
Practice Address - Phone:510-538-4414
Practice Address - Fax:510-889-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14313111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty