Provider Demographics
NPI:1265490890
Name:BRUCE, WILLIAM HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:BRUCE
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:520 SUPERIOR AVE STE 255
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3668
Mailing Address - Country:US
Mailing Address - Phone:949-760-8275
Mailing Address - Fax:949-340-8034
Practice Address - Street 1:520 SUPERIOR AVE STE 255
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3668
Practice Address - Country:US
Practice Address - Phone:949-760-8275
Practice Address - Fax:949-340-8034
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2015-06-17
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Provider Licenses
StateLicense IDTaxonomies
CAG12358207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACQ448AMedicare PIN