Provider Demographics
NPI:1932403540
Name:BARTON, BRUCE EDGAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:EDGAR
Last Name:BARTON
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 1:808 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-6030
Mailing Address - Country:US
Mailing Address - Phone:619-232-4311
Mailing Address - Fax:619-515-8070
Practice Address - Street 1:808 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-6030
Practice Address - Country:US
Practice Address - Phone:619-232-4311
Practice Address - Fax:619-515-8070
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI41715-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine