Provider Demographics
NPI:1154347169
Name:SMYLE, BERNARD ALAN (MD)
Entity type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:ALAN
Last Name:SMYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7667
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93006-7667
Mailing Address - Country:US
Mailing Address - Phone:805-340-4650
Mailing Address - Fax:805-667-9015
Practice Address - Street 1:1497 VISTA DEL MAR DR
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-3733
Practice Address - Country:US
Practice Address - Phone:053-404-6508
Practice Address - Fax:805-667-9015
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-02-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG54868207Q00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine