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General NPI Number Information
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NPI Number | 1033249271
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Entity Type | Organization
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Legal Business Name | FAUSTINO BERNADETT M.D.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1040 ELM AVE STE 100
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City | LONG BEACH
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State | CA
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Zip | 90813-3265
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Country | US
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Telephone | 562-491-2145
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Fax | 562-491-0153
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Provider Business Mailing Address
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Address Line | 1040 ELM AVE STE 100
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City | LONG BEACH
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State | CA
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Zip | 90813-3265
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Country | US
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Telephone | 562-491-2145
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Fax | 562-491-0153
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Authorized Official
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Title or Position | PHYSICIAN ASST.
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Name | MR. ERIC K VOLDENG
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Credential | PA
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Telephone | 562-491-2145
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | PA15918
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License Number State | CA
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