MEDICARE: DR. JOHN BRUCE DORSEY MD

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
1	207X00000X	Orthopaedic Surgery Physician	G18078	CA

General Provider Information

NPI Number	:	1346393659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN BRUCE DORSEY MD

Provider Business Mailing Address
First Line	:	25431 CABOT RD
Second Line	:	#110
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5518
Country	:	US
Telephone Number	:	949-716-1900
Fax Number	:	949-716-1919

Provider Business Practice Location Address
First Line	:	25431 CABOT RD
Second Line	:	#110
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5518
Country	:	US
Telephone Number	:	949-716-1900
Fax Number	:	949-716-1919

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/09/2007

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