Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 13280 | CA |
NPI | 1336268598 |
---|---|
Provider Name | Dr. Mike Eugene Bernd |
First Address | Santa Rosa, CA 95405-5243 |
Second Address | Santa Rosa, CA 95405-5243 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/07/2007 |