Provider Demographics
NPI:1861492738
Name:MICHLIN, BERNARD ARON (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:ARON
Last Name:MICHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6367 ALVARADO CT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4904
Mailing Address - Country:US
Mailing Address - Phone:619-583-1954
Mailing Address - Fax:619-583-2875
Practice Address - Street 1:6367 ALVARADO CT
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4904
Practice Address - Country:US
Practice Address - Phone:619-583-1954
Practice Address - Fax:619-583-2875
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG43755207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G437550Medicaid
CAA92437Medicare UPIN
CA00G437550Medicaid