Provider Demographics
NPI:1801865688
Name:BELL, BRYAN LEE (DPM)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:LEE
Last Name:BELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32369 CASTLE CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-7109
Mailing Address - Country:US
Mailing Address - Phone:951-303-3910
Mailing Address - Fax:760-725-0051
Practice Address - Street 1:NAVHSOP CAMP PENDLETON
Practice Address - Street 2:BOX 555191
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-1619
Practice Address - Fax:760-725-0051
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000872213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery