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NPI Code Detail

MEDICARE: RICHARD A BERNSTEIN DO

MEDICARE: RICHARD A BERNSTEIN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician20A6688CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
177-0458316OTHERCATAX ID

General Provider Information

NPI Number : 1750485777
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD A BERNSTEIN DO
Provider Business Mailing Address
First Line : 4170 GROSS ROAD EXT
Second Line : STE 6
City : CAPITOLA
State : CA
Zip : 95010-2054
Country : US
Telephone Number : 561-241-9300
Fax Number : 561-515-8865
Provider Business Practice Location Address
First Line : 4400 CAPITOLA RD
Second Line : SUITE 200
City : CAPITOLA
State : CA
Zip : 95010-3571
Country : US
Telephone Number : 408-364-6799
Fax Number : 408-378-4510
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2006
Last Update Date : 01/25/2017

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