Healthcare Provider Details

I. General information

NPI: 1811488653
Provider Name (Legal Business Name): MEGAN LOPEZ BERNHARD OD, FAAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 MASS AVE
ARLINGTON MA
02476-4315
US

IV. Provider business mailing address

917 CONCORD CT
VISTA CA
92081-8925
US

V. Phone/Fax

Practice location:
  • Phone: 781-876-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5322
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: