Organization
MARK BERNHARD, D.O. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DOUGLAS BERNHARD D.O. (OWNER)
(626) 584-1112
Entity
Organization
Contact information
Practice address
1060 E GREEN ST, SUITE 107, PASADENA, CA 91106-2413
(626) 584-1112
(626) 584-0453
Mailing address
1060 E GREEN ST, SUITE 107, PASADENA, CA 91106-2413
(626) 584-1112
(626) 584-0453
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
20A4471
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A4471
LICENSE
CA
Enumeration date
05/11/2007
Last updated
08/22/2020
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