Provider Demographics
NPI:1649593260
Name:PINNEY, BRUCE H
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:H
Last Name:PINNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1872
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91944-1872
Mailing Address - Country:US
Mailing Address - Phone:619-200-5356
Mailing Address - Fax:619-328-9611
Practice Address - Street 1:P.O. BOX
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91944
Practice Address - Country:UM
Practice Address - Phone:619-200-5356
Practice Address - Fax:619-328-9611
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator