Provider Demographics
NPI:1366402711
Name:BERENSON, YEHUDA ARI (MD)
Entity type:Individual
Prefix:DR
First Name:YEHUDA
Middle Name:ARI
Last Name:BERENSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARI
Other - Middle Name:
Other - Last Name:BERENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1464 GLENVILLE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-3120
Mailing Address - Country:US
Mailing Address - Phone:310-553-2377
Mailing Address - Fax:
Practice Address - Street 1:450 E HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3748
Practice Address - Country:US
Practice Address - Phone:626-795-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65080207R00000X, 208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist