Provider Demographics
NPI:1871300269
Name:BERNI, MICHAEL MAJED (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MAJED
Last Name:BERNI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15879 BARREL CACTUS LN
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-1449
Mailing Address - Country:US
Mailing Address - Phone:760-792-3431
Mailing Address - Fax:
Practice Address - Street 1:12241 INDUSTRIAL BLVD STE 210
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8301
Practice Address - Country:US
Practice Address - Phone:800-489-6905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist