Provider Demographics
NPI:1598937807
Name:ALLEN, BRUCE BARNES (DC)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:BARNES
Last Name:ALLEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8525 GIBBS DR 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1765
Mailing Address - Country:US
Mailing Address - Phone:858-268-8525
Mailing Address - Fax:
Practice Address - Street 1:8525 GIBBS DR 205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1765
Practice Address - Country:US
Practice Address - Phone:858-268-8525
Practice Address - Fax:858-268-8526
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-26
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor