Provider Demographics
NPI:1346393659
Name:DORSEY, JOHN BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRUCE
Last Name:DORSEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25431 CABOT RD
Mailing Address - Street 2:#110
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5518
Mailing Address - Country:US
Mailing Address - Phone:949-716-1900
Mailing Address - Fax:949-716-1919
Practice Address - Street 1:25431 CABOT RD
Practice Address - Street 2:#110
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5518
Practice Address - Country:US
Practice Address - Phone:949-716-1900
Practice Address - Fax:949-716-1919
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG18078207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90525Medicare UPIN