Individual
BRUCE CHARLES DAUGHERTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5301 W 119TH PL, INGLEWOOD, CA 90304-1019
(310) 675-9285
Mailing address
5301 W 119TH PL, INGLEWOOD, CA 90304-1019
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C40455
CA
Other
Enumeration date
06/28/2005
Last updated
10/01/2013
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