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General NPI Number Information
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NPI Number | 1760689426
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Entity Type | Organization
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Legal Business Name | YOVANA BRUNO PEDIATRIC CARE INC.
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 07/10/2020
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Provider Practice Location Address
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Address Line | 3553 CAMINO MIRA COSTA STE D
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3512
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Country | US
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Telephone | 949-200-7737
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Fax | 949-336-1949
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Provider Business Mailing Address
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Address Line | 3553 CAMINO MIRA COSTA STE D
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-3512
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Country | US
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Telephone | 949-200-7737
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Fax | 949-336-1949
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Authorized Official
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Title or Position | OWNER
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Name | YOVANA GRACIELA BRUNO
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Credential | M.D
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Telephone | 949-200-7737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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