Organization
BRUCE B CHISHOLM MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE B CHISHOLM M.D. (PRESIDENT)
(760) 779-9559
Entity
Organization
Contact information
Practice address
39300 BOB HOPE DR, BANNAN BLDG SUITE 1208, RANCHO MIRAGE, CA 92270-7088
(760) 779-9559
Mailing address
39300 BOB HOPE DR, BANNAN BLDG SUITE 1208, RANCHO MIRAGE, CA 92270-7088
(760) 779-9559
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
G81937
CA
208200000X
Plastic Surgery Physician
G81937
CA
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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