| J. Dustin Bernard, D.o., Medical Corporation | |
|
2074 Parker St Suite 120 San Luis Obispo CA 93401-5052 | |
| (805) 546-9911 | |
| (805) 546-9933 |
| Full Name | J. Dustin Bernard, D.o., Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 2074 Parker St, San Luis Obispo, California |
| Authorized Official Name and Position | Jeanne Dustin Bernard (PRESIDENT) |
| Authorized Official Contact | 8055469911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Dustin Bernard, D.o., Medical Corporation Po Box 12338 San Luis Obispo CA 93406-2338 Ph: (805) 546-9911 | J. Dustin Bernard, D.o., Medical Corporation 2074 Parker St Suite 120 San Luis Obispo CA 93401-5052 Ph: (805) 546-9911 |
| NPI Number | 1700807906 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 01/29/2010 |
| Medicare PECOS PAC ID | 3375430168 |
|---|---|
| Medicare Enrollment ID | O20040304000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700807906 | NPI | - | NPPES |
| C2414859 | Other | CA | STATE DEPT OF CORPORATIONS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | 2414859 (California) | Primary |
| Provider Name | Jeanne D Bernard |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1932133238 PECOS PAC ID: 2769370550 Enrollment ID: I20040308000489 |
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