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NPI Code Detail

MEDICARE: BRUCE H. VAN VRANKEN, M.D., INC

MEDICARE: BRUCE H. VAN VRANKEN, M.D., INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/CenterG32570CA

General Provider Information

NPI Number : 1467674234
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRUCE H. VAN VRANKEN, M.D., INC
Provider Business Mailing Address
First Line : 24400 MUIRLANDS BLVD
Second Line : SUITE F
City : LAKE FOREST
State : CA
Zip : 92630-3946
Country : US
Telephone Number :
Fax Number : 949-581-0694
Provider Business Practice Location Address
First Line : 24400 MUIRLANDS BLVD
Second Line : SUITE F
City : LAKE FOREST
State : CA
Zip : 92630-3946
Country : US
Telephone Number : 949-581-0400
Fax Number : 949-581-0694
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRUCE HARRIS VAN VRANKEN
Credential : M.D.
Telephone Number : 949-581-0400
Provider Enumeration Date : 05/02/2007
Last Update Date : 08/22/2020

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