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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
A40519 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | 008405191 | 05 |
Street Address |
8610 S. SEPULVEDA BLVD. |
City | LOS ANGELES |
State | CA |
Zip Code | 90045 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396388849 | Laska Dental Inc | Dentist | 5602 W Manchester Ave, Los Angeles, CA 90045 | 2019-10-28 |
1245889179 | Ana Arias | Physical Therapist | 6801 Terrace Drive, Suite 200, Los Angeles, CA 90045 | 2019-09-04 |
1144719410 | Family Dental Care 4 You | Dentist | 5602 W. Manchester Ave, Los Angeles, CA 90045 | 2018-05-02 |
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 |
1639688831 | Kalila Magbanua-stein | Counselor | 8618 La Tijera Blvd., Suite 200, Los Angeles, CA 90045 | 2017-09-20 |
1568984185 | Angela Mull | Marriage & Family Therapist | 8616 Latijera Blvd, Suite 307, Los Angeles, CA 90045 | 2017-07-14 |
1386171585 | Patricia Ann Bridewell | Registered Nurse | 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045 | 2017-05-18 |
1679937627 | Thelese Consulting Group | Community/Behavioral Health | 8929 S. Sepulveda Blvd, Suite 400, Los Angeles, CA 90045 | 2016-04-06 |
1568823318 | Keith Romalis Ellison | Specialist/Technologist | One Lmu Drive, Gersten Pavilion - Athletic Training Room, Los Angeles, CA 90045 | 2016-03-08 |
Find all providers in zip 90045 |
Taxonomy Code | 2084N0600X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Clinical Neurophysiology |
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] |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316560378 | Green Flash Physician Oversight PC | Psychiatry & Neurology | 2868 Bayside Walk Unit C, San Diego, CA 92109-8119 | 2020-05-26 |
1659994739 | Jey Neuro Center, Inc | Psychiatry & Neurology | 2005 Eye Street #8-501, Bakersfield, CA 93301-4451 | 2020-05-22 |
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 |
1225530637 | Iom Neuro Pro Reader | Psychiatry & Neurology | 9300 Santa Anita Ave, Suite 101, Rancho Cucamonga, CA 91730 | 2018-03-01 |
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 |
1013180355 | Irving Lee Gislason | Psychiatry & Neurology | 12443 Lewis St Ste 101, Garden Grove, CA 92840-4650 | 2008-04-08 |
1124248844 | Baldev S Rai Md Inc | Psychiatry & Neurology | 4234 Riverwalk Pkwy Ste 280, Riverside, CA 92505-3370 | 2007-04-26 |
Find all providers with the same taxonomy |
City | LOS ANGELES |
Zip Code | 90045 |
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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.