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NPI Code Detail

MEDICARE: MS. DEANNA P. BERNARDINO RNP

MEDICARE: MS. DEANNA P. BERNARDINO RNP
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
1363LF0000XFamily Nurse Practitioner375078CA

General Provider Information

NPI Number : 1649296476
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEANNA P. BERNARDINO RNP
Provider Business Mailing Address
First Line : 400 W 30TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-3320
Country : US
Telephone Number : 213-284-3200
Fax Number :
Provider Business Practice Location Address
First Line : 400 W 30TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-3320
Country : US
Telephone Number : 213-284-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 09/22/2015

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