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NPI Code Detail

MEDICARE: DR. KENNETH BERNSTEIN M.D.

MEDICARE: DR. KENNETH BERNSTEIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA30137CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A30137OTHERCAPHYSICIAN LICENSE

General Provider Information

NPI Number : 1366425357
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH BERNSTEIN M.D.
Provider Business Mailing Address
First Line : PO BOX 299
Second Line :
City : MADERA
State : CA
Zip : 93639-0299
Country : US
Telephone Number : 559-664-4000
Fax Number : 559-675-5224
Provider Business Practice Location Address
First Line : 344 E 6TH ST
Second Line :
City : MADERA
State : CA
Zip : 93638-3631
Country : US
Telephone Number : 559-664-4000
Fax Number : 559-675-5224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 03/07/2023

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