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General NPI Number Information
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NPI Number | 1033154984
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Entity Type | Individual
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Provider Name | BERNARD WOSK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 1121 E WASHINGTON AVE
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City | ESCONDIDO
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State | CA
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Zip | 92025-2214
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Country | US
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Telephone | 760-871-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 5053 ASHBERRY RD
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City | CARLSBAD
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State | CA
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Zip | 92008-3857
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Country | US
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Telephone | 760-931-1229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A49350
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License Number State | CA
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