Individual
DR. BRUCE CALVIN UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DR.P.H.,M.S.E.,M.P.H
Contact information
Practice address
75895 ALTAMIRA DR, INDIAN WELLS, CA 92210-8768
(760) 238-1446
(760) 773-9706
Mailing address
75895 ALTAMIRA DR, INDIAN WELLS, CA 92210-8768
(760) 238-1446
(760) 773-9706
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
CA
133N00000X
Nutritionist
Primary
—
CA
133NN1002X
Nutrition Education Nutritionist
—
CA
174H00000X
Health Educator
—
CA
Other
Enumeration date
07/01/2016
Last updated
07/01/2016
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