Individual
DR. BRUCE LESLIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26800 CROWN VALLEY PKWY, SUITE 315, MISSION VIEJO, CA 92691-6384
(949) 364-6000
(949) 364-1204
Mailing address
26800 CROWN VALLEY PKWY, SUITE 315, MISSION VIEJO, CA 92691-6384
(949) 364-6000
(949) 364-1204
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G046205
CA
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
G046205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G462050
—
CA
Enumeration date
10/20/2005
Last updated
11/06/2008
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