BERNARD LEROY BENNETT


Address: 1510 4th St, Suite 1, Berkeley, CA 94710-1717
Phone: 5105258980

BERNARD LEROY BENNETT (NPI# 1871568899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871568899
Entity Type Individual
Full Name BERNARD LEROY BENNETT
Credential MD
Practice Address 1510 4th St
Suite 1
Berkeley
CA 94710-1717
Practice Telephone 5105258980
Practice Fax Number 5105258982
Mailing Telephone 5105258980
Mailing Fax Number 5105258982
Enumeration Date 2006-02-22
Last Update Date 2017-05-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine C42114 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC BLUE CROSS 1028P 01
NC MEDICARE RAILROAD P00062870 01
NC MEDICARE RAILROAD P00651283 01
NC MEDICARE RAILROAD DO0034 01
NC 891028P 05
NC MEDICARE RAILROAD DA5493 01

Office Location

Street Address 1510 4TH ST
SUITE 1
City BERKELEY
State CA
Zip Code 94710-1717

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447705603 Kimberly Chang Nurse Practitioner 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2016-08-17
1457710998 Naresh Kumar Joshi Internal Medicine 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2016-02-11
1538547237 Firoza Rahimi Nurse Practitioner 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2015-05-13
1013316488 Maki Matsumura Nurse Practitioner 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2014-08-21
1063822187 Amy Lynn Choy Physician Assistant 1510 4th St, Ste 1, Berkeley, CA 94710-1717 2014-04-28
1548605587 Virgilio Y Baluyut Nurse Practitioner 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2013-05-03
1942598289 Christina Garza Internal Medicine 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2011-07-20
1316255094 Linda Beulah Tran Internal Medicine 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2010-09-16
1437489994 Inpatient Consultants of California, Inc Family Medicine 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2010-01-06
1346570801 Inpatient Consultants of California, Inc Family Medicine 1510 4th St, Suite 1, Berkeley, CA 94710-1717 2010-01-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740836857 Elizabeth B. Isono Occupational Therapy Assistant 2550 9th Street, Suite115, Berkeley, CA 94710 2019-08-14
1861967622 Liliana Teves Sierra Nurse Practitioner 837 Addison St, Berkeley, CA 94710 2018-10-09
1841774213 Erin Royle Nurse Practitioner 800 Dwight Way, Berkeley, CA 94710 2018-09-20
1790293389 Nga Thien Ho Pharmacist 1500 Gilman St, Berkeley, CA 94710 2018-01-17
1942710140 Laila Rania Tannura Nurse Practitioner 837 Addison St., Berkeley, CA 94710 2017-10-03
1578016556 Elizaveta Pachepsky Counselor 1061 Eastshore Hwy, Albany, CA 94710 2016-07-26
1245624832 Jody Slendebroek Behavioral Analyst 2560 9th Street Suite 220a, Ste Consultants LLC, Berkeley, CA 94710 2015-03-23
1104234731 Felicia Ma Physician Assistant 2344 Sixth Street, Berkeley, CA 94710 2014-07-28
1699197228 Henriette Agnes Lenssen Acupuncturist 809 Delaware St, Berkeley, CA 94710 2014-01-16
1598198350 Fiona C. Lundy Social Worker 837 Addison Street, Berkeley, CA 94710 2013-08-15
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285249144 Zizmor Medical Group Inc. Internal Medicine 1935 Addison St Ste A, Berkeley, CA 94704-1354 2020-09-08
1861926669 David Kagan Md Inc Internal Medicine 1829 Monterey Ave, Berkeley, CA 94707-2543 2017-04-18
1629435946 Patrick Jerome Scannon Internal Medicine 2910 Seventh St, Berkeley, CA 94710-2700 2016-01-16
1467829879 Laura Wilson Internal Medicine 593 The Alameda, Berkeley, CA 94707-1644 2015-09-02
1053795450 Jenna T Dean Internal Medicine 2540 Ashby Ave, Room 5505, Berkeley, CA 94705-2067 2015-07-15
1679956932 Robert Allan Hiatt Internal Medicine 145 Hillcrest Rd, Berkeley, CA 94705-2808 2015-07-06
1588054076 Hana Holistic Medical Center Internal Medicine 2107 Channing Way, Berkeley, CA 94704-2020 2015-02-04
1639567647 Lee W Riley Internal Medicine 530e Li Ka Shing Bldg, School of Public Health, University of California, Berkeley, CA 94720-3369 2014-12-26
1316217441 Michael Lance Seal Internal Medicine 1844 San Ramon Ave, Berkeley, CA 94707-1645 2012-01-05
1467721902 Carol West Internal Medicine 701 Panoramic Way, Berkeley, CA 94704-2538 2011-12-28
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Competitor

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City BERKELEY
Zip Code 94710

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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