Provider Demographics
NPI:1720214729
Name:ALEJANDRINO, BERNADETTE P (MD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:P
Last Name:ALEJANDRINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 S SUNSET AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3546
Mailing Address - Country:US
Mailing Address - Phone:626-634-8882
Mailing Address - Fax:626-699-4444
Practice Address - Street 1:767 S SUNSET AVE STE 8
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3546
Practice Address - Country:US
Practice Address - Phone:626-634-8882
Practice Address - Fax:626-699-4444
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA121496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program