# BRUCE E. ELLISON, MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922031376
- **Authorized official:** DR. BRUCE E ELLISON MD (PRESIDENT)
- **Authorized official phone:** (650) 366-4585

## Contact information

- **Practice address:** 2940 WHIPPLE AVE, SUITE E, REDWOOD CITY, CA 94062-2857
- **Practice address phone:** (650) 366-4585
- **Practice address fax:** (650) 366-3896
- **Mailing address:** 2940 WHIPPLE AVE, SUITE E, REDWOOD CITY, CA 94062-2857
- **Mailing address phone:** (650) 366-4585
- **Mailing address fax:** (650) 366-3896

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 08/22/2020