Provider Demographics
NPI:1336442250
Name:ANNETTE BERNHUT D O INC.
Entity type:Organization
Organization Name:ANNETTE BERNHUT D O INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNHUT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-997-2899
Mailing Address - Street 1:845 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1622
Mailing Address - Country:US
Mailing Address - Phone:714-997-2899
Mailing Address - Fax:714-289-7062
Practice Address - Street 1:845 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1622
Practice Address - Country:US
Practice Address - Phone:714-997-2899
Practice Address - Fax:714-289-7062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty