Provider Demographics
NPI:1336293927
Name:PINEDA, BERNARD F (PT)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:F
Last Name:PINEDA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4736 MICHELLE WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5039
Mailing Address - Country:US
Mailing Address - Phone:551-208-0345
Mailing Address - Fax:510-487-5759
Practice Address - Street 1:4736 MICHELLE WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-5039
Practice Address - Country:US
Practice Address - Phone:551-208-0345
Practice Address - Fax:510-487-5759
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
022781-1225100000X
CA033167225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist