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General NPI Number Information
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NPI Number | 1558366047
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Entity Type | Individual
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Provider Name | BRUCE J DREYFUSS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 25 N 14TH ST STE 890
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City | SAN JOSE
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State | CA
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Zip | 95112-6216
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Country | US
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Telephone | 408-288-6623
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Fax | 408-288-6698
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Provider Business Mailing Address
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Address Line | 25 N 14TH ST STE 890
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City | SAN JOSE
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State | CA
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Zip | 95112-6216
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Country | US
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Telephone | 408-288-6623
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Fax | 408-288-6698
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | G64297
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2471B0102X
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Taxonomy Name | Bone Densitometry Radiologic Technologist
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License Number | RHC142268
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | FAC52131
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License Number State | CA
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