MEDICARE: BERNARDI MEDICAL GROUP PLLC

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	2083P0901X	Public Health & General Preventive Medicine Physician

General Provider Information

NPI Number	:	1609636695
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERNARDI MEDICAL GROUP PLLC

Provider Business Mailing Address
First Line	:	905 DALTON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4803
Country	:	US
Telephone Number	:	858-997-9105
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 DALTON DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4803
Country	:	US
Telephone Number	:	858-997-9105
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK BERNARDI
Credential	:	MD
Telephone Number	:	858-997-9105

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/19/2024

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