Nickerson, Bruce Greenwood

Nickerson, Bruce Greenwood is an individual health care provider with primary practice located at 455 S Main St , Orange CA 92868-3835. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, Allopathic & Osteopathic Physicians / Pediatric Pulmonology. Allopathic & Osteopathic Physicians / Pediatric Pulmonology is his primary health care specialty. Nickerson, Bruce Greenwood can be contacted via phone (714) 532-8620.

Contact Information

Primary practice address
455 S Main St Orange CA 92868-3835
Phone: (714) 532-8620
Fax: (714) 289-4072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X G38843 California
Allopathic & Osteopathic Physicians / Pediatric Pulmonology 2080P0214X G38843 California

Profile Details

NPI number 1215026521
LBN Legal business name Nickerson, Bruce Greenwood
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Aug 8th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215026521 NPPES
California MEDICAID 00G388430
California Other WG38843F

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