Marc Benedict E Bernaldez, MLS(ASCP)CM

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

License

MTA00043890 Issued in CA

Practice address

18054 Epic LN
Santa Clarita, CA 91350-3270

Phone

(818) 687-6653

NPI assigned

Feb 3, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1477206993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18054 EPIC LN",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913503270",
            "telephone_number": "818-687-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18054 EPIC LN",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913503270",
            "telephone_number": "818-687-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNALDEZ",
        "first_name": "MARC BENEDICT",
        "middle_name": "E",
        "credential": "MLS(ASCP)CM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "CA",
            "license": "MTA00043890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lab@epicwavelaboratory.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "18054 Epic Ln",
            "city": "Santa Clarita",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913503270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Laboratory Director (Non-physician) in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Clinical Laboratory Director (Non-physician) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.