Provider Demographics
NPI:1811147069
Name:CRUZ, BRYAN P (MD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:P
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:305 EAST CENTER AVE.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6331
Mailing Address - Country:US
Mailing Address - Phone:559-737-4700
Mailing Address - Fax:559-737-4782
Practice Address - Street 1:400 EAST OAK STREET
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5034
Practice Address - Country:US
Practice Address - Phone:559-741-4500
Practice Address - Fax:559-741-4502
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA118399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine