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Contact Information

BERNARDO DERMATOLOGY MEDICAL GROUP INC
15525 POMERADO RD
SUITE A2
POWAY, CA92064-2435
 Phone: 858-451-3311
 Fax: 858-451-1142
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for BERNARDO DERMATOLOGY MEDICAL GROUP INC

NPI # 1407950785
LBN Legal business name BERNARDO DERMATOLOGY MEDICAL GROUP INC
Authorized official RUTH LARSON - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/08/2006
Last updated 11/06/2007 - About 19 years ago
Identifiers
CA License # G41388
CA License # G49647
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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