Provider Demographics
NPI:1952504557
Name:BERNAL, ANDREW A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:A
Last Name:BERNAL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29713 NIGUEL RD APT H
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-5002
Mailing Address - Country:US
Mailing Address - Phone:562-382-5844
Mailing Address - Fax:
Practice Address - Street 1:800 N TUSTIN AVE STE A
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3605
Practice Address - Country:US
Practice Address - Phone:714-245-0800
Practice Address - Fax:714-912-8202
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA13755363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical