Provider Demographics
NPI:1679753586
Name:MARQUEZ, BRUCE RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:RUSSELL
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9209 COLIMA RD
Mailing Address - Street 2:SUITE 3600
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1800
Mailing Address - Country:US
Mailing Address - Phone:562-693-5854
Mailing Address - Fax:562-693-9135
Practice Address - Street 1:9209 COLIMA RD
Practice Address - Street 2:SUITE 3600
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-1800
Practice Address - Country:US
Practice Address - Phone:562-693-5854
Practice Address - Fax:562-693-9135
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA464382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry