Provider Demographics
NPI:1851495154
Name:HECTOR, BRUCE P (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:P
Last Name:HECTOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 920970
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91392-0970
Mailing Address - Country:US
Mailing Address - Phone:818-361-3788
Mailing Address - Fax:818-361-4630
Practice Address - Street 1:501 N MACLAY AVE
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2424
Practice Address - Country:US
Practice Address - Phone:818-361-3788
Practice Address - Fax:818-361-4630
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2021-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD8841207Q00000X
CAG198500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G198500Medicaid
CA00G198500Medicaid
A40773Medicare UPIN