Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 101240475 | VA |
N | 111NI0900X | Internist | 101240475 | VA |
Y | 207RH0002X | Hospice and Palliative Medicine | MD450465 | PA |
NPI | 1255405502 |
---|---|
Provider Name | Dr. Bertrand Behmlopez |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-4903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 31/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101240475 | LICENSE (01) | VA |
A102580 | CALIFORNIA LICENSE (01) | CA |