Douglas Beernink, MD

Individual provider Active NPI Ophthalmology Physician · Cameron Park, CA

NPI 1992883656 · NPPES record last updated Oct 29, 2008

Key facts

NPI
1992883656
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
A23433 (CA)
Practice address
440 Cragmont CT
Cameron Park, CA 95682-8162
Phone
(530) 672-8780
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A23433CAMDOphthalmology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A23433 CA Yes

Addresses

Primary practice location

440 Cragmont CT
Cameron Park, CA 95682-8162

Mailing address

PO Box 2030
Folsom, CA 95763-2030
Phone (530) 672-8780

Other identifiers

IdentifierTypeStateIssuer
00A234330MedicaidCA

Other providers in Cameron Park, CA

All providers in Cameron Park, CA · Ophthalmology Physician in California

Sources for this page

Verify at the official NPI Registry.