Provider Demographics
NPI:1841387982
Name:DAVIDORF, BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:DAVIDORF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7320 WOODLAKE AVE
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1468
Mailing Address - Country:US
Mailing Address - Phone:818-883-0112
Mailing Address - Fax:818-883-2767
Practice Address - Street 1:7320 WOODLAKE AVE
Practice Address - Street 2:SUITE 190
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1468
Practice Address - Country:US
Practice Address - Phone:818-883-0112
Practice Address - Fax:818-883-2767
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2013-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC28433207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C284330Medicaid
CAA33632Medicare UPIN