RANDY E. BERGEN (NPI# 1316025497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316025497 |
| Entity Type | Individual |
| Full Name | RANDY E. BERGEN |
| Credential | MD |
| Practice Address |
1425 S Main St Walnut Creek CA 94596-5318 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 9252954000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
G52916 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G529160 | 05 |
| Street Address |
1425 S MAIN ST |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342638 | Ingrid Wendy Fernandes | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2005-08-09 |
| 1982221297 | Michelle Nhumai Huynh | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-07-02 |
| 1144869322 | Darrell James David | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-01-05 |
| 1306484530 | Kayla Galanter | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-12-18 |
| 1184260804 | Carol Jean Mcmenamy | Social Worker | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-18 |
| 1871138990 | Gloria Yatmen Lai | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-12 |
| 1851945901 | Zsanell Go | Physical Therapist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-07-26 |
| 1043776453 | Bridget Rochios | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1518423920 | Britnie Lee Milam | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1326503244 | Megan R Moore | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104243666 | Leila Caroline Aurora Posch | Pediatrics | 4650 W Sunset Blvd # 51, Los Angeles, CA 90027-6062 | 2014-03-23 |
| 1164773909 | Beatriz Larru | Pediatrics | 3701 Wilshire Boulevard, Suite #600, Los Angeles, CA 90010-2814 | 2012-09-19 |
| 1700146818 | William V La Via | Pediatrics | 654 Palmera Ave, Pacific Palisades, CA 90272-3356 | 2012-05-22 |
| 1114299757 | Henry R Shinefield | Pediatrics | 1858 N Beverly Dr, Beverly Hills, CA 90210-1611 | 2012-01-28 |
| 1346541026 | Despina G Contopoulos-ioannidis | Pediatrics | 300 Pasteur Drive; Room G312, Stanford Univ Sch.med; Dept Pediatrics, Div. Infect.dis, Stanford, CA 94305 | 2010-11-11 |
| 1942478524 | Pia S Pannaraj | Pediatrics | 4650 Sunset Blvd., Ms#51, Children's Hospital Los Angeles, Los Angeles, CA 90027 | 2008-02-15 |
| 1790867174 | Margaret E Feeney | Pediatrics | 1001 Potrero Ave., Building 3, Room 525, Ucsf Division of Experimental Medicine, San Francisco, CA 94110-3518 | 2006-10-19 |
| 1558441428 | Andrew Michael Wiesenthal | Pediatrics | 555 Mission St, C/o Deloitte Consulting, LLP, San Francisco, CA 94105-0920 | 2006-10-16 |
| 1164511002 | Carol A Glaser | Pediatrics | 500 Parnassus Ave # 0136, San Francisco, CA 94143-2203 | 2006-10-11 |
| 1154429793 | Michael N Neely | Pediatrics | 1640 Marengo St, Hra 300, Los Angeles, CA 90033-1036 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.