Basic Information
| Provider Information | |||||||||
| NPI: | 1831127497 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELPEDES | ||||||||
| FirstName: | BERNARD | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 POWELL ST | ||||||||
| Address2: | STE 920 | ||||||||
| City: | EMERYVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946081826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103502777 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 23962 ALICIA PKWY, SUITE I1 | ||||||||
| Address2: | |||||||||
| City: | MISSION VIEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926913940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9494527699 | ||||||||
| FaxNumber: | 9497702815 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2006 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A6887 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.