Provider Demographics
NPI:1326332735
Name:BERN, STANLEY M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:M
Last Name:BERN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11720 BLOSSOMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3314
Mailing Address - Country:US
Mailing Address - Phone:805-523-2007
Mailing Address - Fax:
Practice Address - Street 1:11720 BLOSSOMWOOD CT
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3314
Practice Address - Country:US
Practice Address - Phone:805-523-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272671835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy