Provider Demographics
NPI:1649356155
Name:BERNAL, MARIA-PILAR (MD)
Entity type:Individual
Prefix:
First Name:MARIA-PILAR
Middle Name:
Last Name:BERNAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-853-2904
Mailing Address - Fax:
Practice Address - Street 1:370 DISTEL CIR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022
Practice Address - Country:US
Practice Address - Phone:650-254-5200
Practice Address - Fax:650-254-5285
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA402032084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A402030Medicaid
CA00A402030Medicaid
00A402030Medicare ID - Type Unspecified