Provider Demographics
NPI:1437256583
Name:BRUCE R. EICH, MD PC
Entity Type:Organization
Organization Name:BRUCE R. EICH, MD PC
Other - Org Name:TEMPE OBSTETRICS AND GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:EICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-820-9000
Mailing Address - Street 1:2163 E BASELINE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1541
Mailing Address - Country:US
Mailing Address - Phone:480-820-9000
Mailing Address - Fax:480-820-6413
Practice Address - Street 1:2163 E BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1541
Practice Address - Country:US
Practice Address - Phone:480-820-9000
Practice Address - Fax:480-820-6413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD88873Medicare UPIN
AZ16WCHHL06Medicare ID - Type Unspecified