Individual
DR. BRUCE J DREYFUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 N 14TH ST, STE 890, SAN JOSE, CA 95112-6216
(408) 288-6623
(408) 288-6698
Mailing address
25 N 14TH ST, STE 890, SAN JOSE, CA 95112-6216
(408) 288-6623
(408) 288-6698
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
G64297
CA
2471B0102X
Bone Densitometry Radiologic Technologist
RHC142268
CA
261QR0200X
Radiology Clinic/Center
FAC52131
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110048492
RAILROAD MEDICARE
CA
05
—
5148629
—
CA
01
—
660003967
RAILROAD MEDICARE
CA
01
—
ZZZ54863Z
BLUE SHIELD #
CA
Enumeration date
06/20/2005
Last updated
02/05/2009
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