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Individual

BRUCE M ESPENSHADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
401 BICENTENNIAL WAY, SANTA ROSA, CA 95403-2149
(707) 963-6399
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
42342
KY
207Q00000X
Family Medicine Physician
42342
KY
207Q00000X
Family Medicine Physician
Primary
C139297
CA
208M00000X
Hospitalist Physician
C139297
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000601798
BCBS
KY
01
000000759205
ANTHEM-NICC
KY
05
201140380
IN
05
7100068760
KY
01
K042110
MEDICARE- NORTON HEALTHCARE
KY
Enumeration date
04/10/2007
Last updated
10/14/2024
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