Organization
CLINIC808 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT DALE BERNAUER JR. MD (OWNER)
(337) 564-0001
Entity
Organization
Contact information
Practice address
6105 W MYRTLE BAY DR, LAKE CHARLES, LA 70605-3149
(337) 564-0001
Mailing address
6105 W MYRTLE BAY DR, LAKE CHARLES, LA 70605-3149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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