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Organization

J. DUSTIN BERNARD, D.O., MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEANNE DUSTIN BERNARD D.O. (PRESIDENT)
(805) 546-9911
Entity
Organization

Contact information

Practice address
2074 PARKER ST, SUITE 120, SAN LUIS OBISPO, CA 93401-5052
(805) 546-9911
(805) 546-9933
Mailing address
PO BOX 12338, SAN LUIS OBISPO, CA 93406-2338
(805) 546-9911
(805) 546-9933

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2414859
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C2414859
STATE DEPT OF CORPORATIONS NUMBER
CA
Enumeration date
07/22/2006
Last updated
01/29/2010
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