Individual
BRUCE K REISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3907 WARING RD STE 1A, OCEANSIDE, CA 92056-4454
(760) 724-8749
(760) 724-2604
Mailing address
3907 WARING RD STE 1A, OCEANSIDE, CA 92056-4454
(760) 724-8749
(760) 724-2604
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G59056
CA
207Y00000X
Otolaryngology Physician
LT4368
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G590560
BLUE SHIELD
CA
05
—
00G590560
—
CA
Enumeration date
08/08/2006
Last updated
11/16/2022
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