Provider Demographics
NPI:1154964245
Name:BERNALDO, WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BERNALDO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8996 MIRAMAR RD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4463
Mailing Address - Country:US
Mailing Address - Phone:760-688-0127
Mailing Address - Fax:
Practice Address - Street 1:8996 MIRAMAR RD STE 301
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4463
Practice Address - Country:US
Practice Address - Phone:760-688-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2917722251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology