Provider Demographics
NPI:1235949132
Name:SIGURD BERVEN MD INC
Entity type:Organization
Organization Name:SIGURD BERVEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIGURD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERVEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-577-1489
Mailing Address - Street 1:2400 SAMARITAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-3910
Mailing Address - Country:US
Mailing Address - Phone:408-583-4697
Mailing Address - Fax:408-577-1489
Practice Address - Street 1:2400 SAMARITAN DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3910
Practice Address - Country:US
Practice Address - Phone:408-583-4697
Practice Address - Fax:408-577-1489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty