Provider Demographics
NPI:1639173974
Name:URLAUB, BERNARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:J
Last Name:URLAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 RESERVOIR DR.
Mailing Address - Street 2:STE. 206
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5101
Mailing Address - Country:US
Mailing Address - Phone:619-287-6003
Mailing Address - Fax:619-287-6038
Practice Address - Street 1:5555 RESERVOIR DR.
Practice Address - Street 2:STE. 206
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5101
Practice Address - Country:US
Practice Address - Phone:619-287-6003
Practice Address - Fax:619-287-6038
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC339882086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C339880Medicaid
CA00C339880Medicaid
CAC33988Medicare ID - Type Unspecified