Richard L Bruck M D a Professional Corporation

NPI #1194913624 in Upland, California

Provider Information

NPI Number: 1194913624
Entity Type: Organization
Organization Name: Richard L Bruck M D a Professional Corporation
Primary Specialty: Specialist
Enumeration Date: Oct 10, 2007
Last Updated: Oct 23, 2012

Practice Location

Address: 591 N 13TH AVE
Address 2: STE.3
City: Upland
State: California
ZIP Code: 91786-4967
Phone: (951) 217-8640

Authorized Official

Name: MR. RICHARD LAWRENCE BRUCK I, MD
Title: OWNER
Phone: (951) 217-8640

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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