Provider Demographics
NPI:1740298991
Name:PATERSON, BRUCE F (MD)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:F
Last Name:PATERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2485 HIGH SCHOOL AVE STE 127
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1812
Mailing Address - Country:US
Mailing Address - Phone:925-685-3033
Mailing Address - Fax:925-685-3003
Practice Address - Street 1:2485 HIGH SCHOOL AVE STE 127
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1812
Practice Address - Country:US
Practice Address - Phone:925-685-3033
Practice Address - Fax:925-685-3003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45545207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G455450Medicaid
CA00G455450Medicaid
CA00G455450Medicare ID - Type Unspecified