Provider Demographics
NPI:1104108992
Name:BERNSTEIN, GALEN E (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GALEN
Middle Name:E
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W SLAUSON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90047-1126
Mailing Address - Country:US
Mailing Address - Phone:323-292-1941
Mailing Address - Fax:323-292-4256
Practice Address - Street 1:1800 W SLAUSON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90047-1126
Practice Address - Country:US
Practice Address - Phone:323-292-1941
Practice Address - Fax:323-292-4256
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55501183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist