Provider Demographics
NPI:1710930052
Name:BERNHARD, GERSON CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:GERSON
Middle Name:CHARLES
Last Name:BERNHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1925 GOUGH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3416
Mailing Address - Country:US
Mailing Address - Phone:415-567-9714
Mailing Address - Fax:415-567-9714
Practice Address - Street 1:1925 GOUGH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3416
Practice Address - Country:US
Practice Address - Phone:415-567-9714
Practice Address - Fax:415-567-9714
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG3717207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B51526Medicare UPIN