Provider Demographics
NPI:1093768186
Name:MORRIS, JEFFREY BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:BRUCE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:477 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C202
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1328
Mailing Address - Country:US
Mailing Address - Phone:760-631-3500
Mailing Address - Fax:760-753-5150
Practice Address - Street 1:477 N EL CAMINO REAL
Practice Address - Street 2:SUITE C202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1328
Practice Address - Country:US
Practice Address - Phone:760-631-3500
Practice Address - Fax:760-753-5150
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA41008207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA85557Medicare UPIN