Individual
MR. BRUCE EDWIN VANNATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 KATELLA AVE, SUITE 401, LOS ALAMITOS, CA 90720-3338
(562) 598-3200
(562) 799-3646
Mailing address
3801 KATELLA AVE, SUITE 401, LOS ALAMITOS, CA 90720-3338
(562) 598-3200
(562) 799-3646
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
C39931
CA
207RI0011X
Interventional Cardiology Physician
Primary
C39931
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C399310
—
CA
Enumeration date
06/22/2005
Last updated
04/23/2019
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