Individual ProviderCarla Demeterco-BerggrenPediatricsAllopathic & Osteopathic PhysiciansPractice Address8110 Birmingham Way, Bldg 28, San Diego, CA 92123-2758(858) 966-4032(858) 309-6303PECOS EnrollmentBased on the most recent information from CMS, provider Carla Demeterco-Berggren is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 2:29 PM.Profile DetailsProvider ID1619130655Provider TypeIndividualFull NameDemeterco-Berggren, CarlaCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date7/9/2008Last Updated7/9/2008Contact InformationPractice LocationPractice Address8110 Birmingham Way, Bldg 28, San Diego, CA 92123-2758Phone(858) 966-4032FaxUnlisted FaxMailing LocationMailing Address3860 Calle Fortunada, Suite 210, San Diego, CA 92123-4800Phone(858) 309-6303FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseA98629CaliforniaCode2080P0205XDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicenseA98629California