Provider Demographics
NPI:1629185012
Name:OZMAN, BRIDGET (MD)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:OZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:
Other - Last Name:ALAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8607 IRVINE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4219
Mailing Address - Country:US
Mailing Address - Phone:949-557-0600
Mailing Address - Fax:
Practice Address - Street 1:8607 IRVINE CENTER DR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4219
Practice Address - Country:US
Practice Address - Phone:949-557-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43808207Q00000X
CAC55162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34310600Medicaid
WIP00989245OtherRR MEDICARE
WI34310600Medicaid
WI027173920Medicare PIN
WIP00989245OtherRR MEDICARE
WI019940678Medicare PIN