Individual
BRUCE S. HEISCHOBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9961 SIERRA AVE, FONTANA, CA 92335-6720
(909) 427-3910
(626) 405-6768
Mailing address
393 E WALNUT ST, 3RD FLOOR - PHR SYSTEMS, PASADENA, CA 91188-0001
(626) 405-7914
(626) 405-6768
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G43994
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G439940
—
CA
Enumeration date
06/29/2007
Last updated
11/22/2021
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