Provider Demographics
NPI:1972699015
Name:KIRSCHNER, BRUCE IRWIN (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:IRWIN
Last Name:KIRSCHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1828 EL CAMINO REAL
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010
Mailing Address - Country:US
Mailing Address - Phone:650-692-8788
Mailing Address - Fax:650-692-8798
Practice Address - Street 1:1828 EL CAMINO REAL
Practice Address - Street 2:SUITE 404
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010
Practice Address - Country:US
Practice Address - Phone:650-692-8788
Practice Address - Fax:650-692-8798
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG44283207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG44283OtherMEDICAL LICENSE
CAG44283OtherMEDICAL LICENSE