Individual
DR. BRUCE RAYMOND BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
814 CLOVERVIEW DR, GLENDORA, CA 91741-1916
(562) 809-6978
Mailing address
814 CLOVERVIEW DR, GLENDORA, CA 91741-1916
(562) 809-6978
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G48195
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G481950
—
CA
Enumeration date
06/12/2006
Last updated
07/13/2009
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