MEDICARE: AVIVA S BERNAT 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
1	207R00000X	Internal Medicine Physician	A98681	CA
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	A98681	CA
3	208VP0000X	Pain Medicine Physician	A98681	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407836323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVIVA S BERNAT M.D.

Provider Business Mailing Address
First Line	:	2118 WILSHIRE BLVD
Second Line	:	#1046
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5784
Country	:	US
Telephone Number	:	323-251-4546
Fax Number	:	413-403-4078

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:	#116
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5363
Country	:	US
Telephone Number	:	310-728-6193
Fax Number	:	413-403-4078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/18/2008

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Directions to “ AVIVA S BERNAT M.D.” Practice Location

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