Healthcare Provider Details

I. General information

NPI: 1023064243
Provider Name (Legal Business Name): DAVID BERNAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4941 DURFEE AVE
PICO RIVERA CA
90660-2417
US

IV. Provider business mailing address

4941 DURFEE AVE
PICO RIVERA CA
90660-2417
US

V. Phone/Fax

Practice location:
  • Phone: 562-908-3988
  • Fax: 562-692-2319
Mailing address:
  • Phone: 562-908-3988
  • Fax: 562-692-2319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA43703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: