Provider Demographics
NPI:1720351208
Name:ROBERT F. BERNSTEIN, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT F. BERNSTEIN, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-327-7666
Mailing Address - Street 1:555 E TACHEVAH DR
Mailing Address - Street 2:BUILDING 1 WEST, SUITE 202
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-5750
Mailing Address - Country:US
Mailing Address - Phone:760-327-7666
Mailing Address - Fax:760-322-6244
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:BUILDING 1 WEST, SUITE 202
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-327-7666
Practice Address - Fax:760-322-6244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37476207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G374760Medicare PIN