Individual
BERNARD SONGCO BACAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 NORMAN DR, STE 103, MANTECA, CA 95336-5900
(209) 825-6331
(209) 825-6351
Mailing address
1140 NORMAN DR, STE 103, MANTECA, CA 95336-5900
(209) 825-6331
(209) 825-6351
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A76551
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0099130
—
CA
Enumeration date
07/15/2006
Last updated
01/02/2008
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