Provider Demographics
NPI:1184796625
Name:BERNSTEIN, COLIN RODNEY (OD)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:RODNEY
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9834 GENESEE AVE
Mailing Address - Street 2:SUITE 428
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1223
Mailing Address - Country:US
Mailing Address - Phone:858-457-1200
Mailing Address - Fax:858-597-2027
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:SUITE 428
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1223
Practice Address - Country:US
Practice Address - Phone:858-457-1200
Practice Address - Fax:858-597-2027
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA6872T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist