# BERNARD MONDERER MD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912981101
- **Authorized official:** BERNARD MONDERER MD (OWNER)
- **Authorized official phone:** (818) 786-0710

## Contact information

- **Practice address:** 15211 VANOWEN ST, STE 210, VAN NUYS, CA 91405-3606
- **Practice address phone:** (818) 786-0710
- **Practice address fax:** (818) 786-0712
- **Mailing address:** 15211 VANOWEN ST, STE 210, VAN NUYS, CA 91405-3606
- **Mailing address phone:** (818) 786-0710
- **Mailing address fax:** (818) 786-0712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G34153 | CA | Yes |

## Other

- **Enumeration date:** 12/01/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3059218 | — | CA |