Provider Demographics
NPI:1134681018
Name:VULCAIN, BERTRAND (MD)
Entity type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:
Last Name:VULCAIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 HUGHES AVE STE 509
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6861
Mailing Address - Country:US
Mailing Address - Phone:925-282-1778
Mailing Address - Fax:208-591-7945
Practice Address - Street 1:3831 HUGHES AVE STE 509
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6861
Practice Address - Country:US
Practice Address - Phone:925-282-1778
Practice Address - Fax:208-591-7945
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA1974032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program