Vannatta, Bruce Edwin
Vannatta, Bruce Edwin is an individual health care provider with primary practice located at 3801 Katella Ave Suite 401, Los Alamitos CA 90720-3338. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Cardiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Vannatta, Bruce Edwin can be contacted via phone (562) 598-3200.Contact Information
Primary practice address
3801 Katella Ave Suite 401
Los Alamitos CA 90720-3338
Phone: (562) 598-3200
Fax: (562) 799-3646
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | C39931 | California |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | C39931 | California |
Profile Details
| NPI number | 1629074877 |
|---|---|
| LBN Legal business name | Vannatta, Bruce Edwin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Apr 23rd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629074877 | NPPES |
| California | MEDICAID | 00C399310 |
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