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Organization
RICHARD L BRUCK M D A PROFESSIONAL CORPORATION
Active
Organization
RICHARD L BRUCK M D A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD LAWRENCE BRUCK I MD (OWNER)
(951) 217-8640
Entity
Organization
Contact information
Practice address
591 N 13TH AVE, STE.3, UPLAND, CA 91786-4967
(951) 217-8640
(909) 920-3379
Mailing address
591 N 13TH AVE, STE.3, UPLAND, CA 91786-4967
(909) 985-5885
(909) 920-3379
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G30560
CA
Other
Enumeration date
10/10/2007
Last updated
10/23/2012
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