Provider Demographics
NPI:1861532871
Name:SKLAR, BERNARD MORTON
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:MORTON
Last Name:SKLAR
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:BERNARD
Other - Middle Name:MORTON
Other - Last Name:SKLAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7200 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2403
Mailing Address - Country:US
Mailing Address - Phone:510-777-3845
Mailing Address - Fax:510-777-3806
Practice Address - Street 1:7200 BANCROFT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2403
Practice Address - Country:US
Practice Address - Phone:510-777-3845
Practice Address - Fax:510-777-3806
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG105162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry