Provider Demographics
NPI:1518936657
Name:BERNET, DANIEL EMIL (OD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:EMIL
Last Name:BERNET
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890 VENTURA ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3553
Mailing Address - Country:US
Mailing Address - Phone:530-365-6471
Mailing Address - Fax:530-365-3332
Practice Address - Street 1:2890 VENTURA ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3553
Practice Address - Country:US
Practice Address - Phone:530-365-6471
Practice Address - Fax:530-365-3332
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6166TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10252Medicare UPIN
CASD0061661Medicare PIN