Healthcare Provider Details

I. General information

NPI: 1396229068
Provider Name (Legal Business Name): SHARON BRUCE CHIROPRACTIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 ATLANTIC AVE STE A10
LONG BEACH CA
90807-2245
US

IV. Provider business mailing address

4425 ATLANTIC AVE STE A10
LONG BEACH CA
90807-2245
US

V. Phone/Fax

Practice location:
  • Phone: 562-961-7660
  • Fax:
Mailing address:
  • Phone: 562-961-7660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SHARON BRUCE
Title or Position: OWNER/CHIROPRACTOR
Credential: DC
Phone: 562-961-8535