ROGER BERTOLDI MD PROFESSIONAL CORPORATION


Address: 8610 S. Sepulveda Blvd., Los Angeles, CA 90045
Phone: 3106705555

ROGER BERTOLDI MD PROFESSIONAL CORPORATION (NPI# 1952629263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952629263
Entity Type Organization
Organization Name ROGER BERTOLDI MD PROFESSIONAL CORPORATION
Practice Address 8610 S. Sepulveda Blvd.
Los Angeles
CA 90045
Mailing Address 8610 S. Sepulveda Blvd.
Suite 200
Los Angeles
CA 90045
Practice Telephone 3106705555
Practice Fax Number 3106709222
Mailing Telephone 3106705555
Mailing Fax Number 3106709222
Enumeration Date 2010-05-11
Last Update Date 2015-03-19
Authorized Official Name MR. ROGER V BERTOLDI (PHYSICIAN/OWNER)
Authorized Official Telephone 3106705555
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0600X Psychiatry & Neurology
Specialization: Clinical Neurophysiology
A40519 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
CA 008405191 05

Office Location

Street Address 8610 S. SEPULVEDA BLVD.
City LOS ANGELES
State CA
Zip Code 90045

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1821504002 Rhonda Taylor Counselor 8703 La Tijera Blvd Ste 201, Los Angeles, CA 90045 2017-12-24
1114436839 Blanca Melisa Gomez I Case Manager/Care Coordinator 7423 1/4 S Sepulveda Blvd, Los Angeles, CA 90045 2017-09-26
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Taxonomy Information

Taxonomy Code 2084N0600X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Clinical Neurophysiology

Taxonomy Definition

Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS).
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1578116877 La Neuro Medical Group Psychiatry & Neurology 11843 Dorothy St Apt 2, Los Angeles, CA 90049-4456 2019-07-17
1780935130 Dawn Eliashiv Md Inc. A Professional Medical Corporation Psychiatry & Neurology 8635 W 3rd St Ste 1080w, Los Angeles, CA 90048-6183 2012-09-25
1396278321 Avantis Neuroscience Inc Psychiatry & Neurology 12401 Wilshire Blvd Ste 104, Los Angeles, CA 90025-1015 2017-04-06
1063704641 Michael Galen Gibbs Psychiatry & Neurology 710 Westwood Plz, Los Angeles, CA 90095-8353 2011-05-13
1477877272 David S Campion Md A Medical Corp Psychiatry & Neurology 10780 Santa Monica Blvd, Suite 210, Los Angeles, CA 90025-4749 2010-03-23

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1518527613 Neuroguard Pro Psychiatry & Neurology 2932 N Cottonwood St Unit 16, Orange, CA 92865-1235 2019-06-19
1750857801 Tms Depression Center of San Diego Psychiatry & Neurology 613 W Valley Pkwy Ste 102, Escondido, CA 92025-2550 2018-10-16
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1437579851 Sami Bajwa Psychiatry & Neurology 7240 N Van Ness Blvd, Fresno, CA 93711-0470 2014-04-24
1073821922 Yuvraj Singh Grewal Psychiatry & Neurology 23861 Mcbean Pkwy Ste A4, Santa Clarita, CA 91355-2003 2010-09-14
1063686202 Mark E Vonzastrow Psychiatry & Neurology 600 16th St, N212e Genentech Hall / Ucsf, San Francisco, CA 94158-2517 2008-04-18
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1124248844 Baldev S Rai Md Inc Psychiatry & Neurology 4234 Riverwalk Pkwy Ste 280, Riverside, CA 92505-3370 2007-04-26
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Competitor

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City LOS ANGELES
Zip Code 90045

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Dataset Information

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.

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