Provider Demographics
NPI:1366850174
Name:BERNHARD A. VOTTERI MD, INC
Entity Type:Organization
Organization Name:BERNHARD A. VOTTERI MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOTTERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-440-0403
Mailing Address - Street 1:3260 MELENDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-0000
Mailing Address - Country:US
Mailing Address - Phone:650-440-0403
Mailing Address - Fax:650-593-9295
Practice Address - Street 1:2900 WHIPPLE AVE
Practice Address - Street 2:SUITE # 115
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2843
Practice Address - Country:US
Practice Address - Phone:650-440-0403
Practice Address - Fax:650-593-9295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21753207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty