=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134271836
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICARDO BERNARDINO M D INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2007
-----------------------------------------------------
Last Update Date | 12/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 714 MAIN ST
-----------------------------------------------------
City | DELANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93215-2953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-721-2220
-----------------------------------------------------
Fax | 661-721-1852
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 714 MAIN ST
-----------------------------------------------------
City | DELANO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93215-2953
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 661-721-2220
-----------------------------------------------------
Fax | 661-721-1852
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RICARDO BERNARDINO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 661-721-2200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A52712
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------