Provider Demographics
NPI:1245397868
Name:HANDWERGER, BRONNER (NMD)
Entity Type:Individual
Prefix:DR
First Name:BRONNER
Middle Name:
Last Name:HANDWERGER
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 VILLA LA JOLLA DRIVE
Mailing Address - Street 2:SUITE A107
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-254-5433
Mailing Address - Fax:866-463-9349
Practice Address - Street 1:8950 VILLA LA JOLLA DRIVE
Practice Address - Street 2:SUITE A107
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-254-5433
Practice Address - Fax:866-463-9349
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2015-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-81175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath