Individual
DR. BRUCE R LAVERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MARINE CORPS AIR GROUND COMBAT CENTER, BOX 788250, TWENTYNINE PALMS, CA 92278-8250
(760) 830-2188
Mailing address
PO BOX 788250, MARINE CORPS AIR GROUND COMBAT CENTER, TWENTYNINE PALMS, CA 92278-8250
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G66108
CA
Other
Enumeration date
04/05/2006
Last updated
07/08/2007
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