Provider Demographics
NPI:1578759759
Name:DR. NAIDE BRUNO D.C. P.C.
Entity Type:Organization
Organization Name:DR. NAIDE BRUNO D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-568-7026
Mailing Address - Street 1:6027 E QUAIL TRACK DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85266-8707
Mailing Address - Country:US
Mailing Address - Phone:602-568-7026
Mailing Address - Fax:480-513-1420
Practice Address - Street 1:6027 E QUAIL TRACK DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85266-8707
Practice Address - Country:US
Practice Address - Phone:602-568-7026
Practice Address - Fax:480-513-1420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ24034Medicare PIN