Provider Demographics
NPI:1477989093
Name:DEBRUIN RESEARCH, INC
Entity Type:Organization
Organization Name:DEBRUIN RESEARCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:IKE
Authorized Official - Last Name:DEBRUIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-989-2929
Mailing Address - Street 1:9352 MADISON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-4981
Mailing Address - Country:US
Mailing Address - Phone:916-989-2929
Mailing Address - Fax:916-989-0322
Practice Address - Street 1:9352 MADISON AVE STE 1
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-4981
Practice Address - Country:US
Practice Address - Phone:916-989-2929
Practice Address - Fax:916-989-0322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5579305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service