MEDICARE: DR. BRUCE MICHAEL SCHLECTER M.D.

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	2084N0400X	Neurology Physician	G31391	CA
2	2084H0002X	Hospice and Palliative Medicine (Psychiatry & Neurology) Physician	G31391	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0G313910	OTHER	CA	CA MEDI-CAL
2	953192779	OTHER	CA	BLUE CROSS OF CA
3	00G313910	OTHER	CA	BLUE SHIELD OF CA

General Provider Information

NPI Number	:	1437125838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE MICHAEL SCHLECTER M.D.

Provider Business Mailing Address
First Line	:	1809 VERDUGO BLVD STE 210
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91208-1402
Country	:	US
Telephone Number	:	818-790-8512
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 VERDUGO BLVD
Second Line	:	#210
City	:	GLENDALE
State	:	CA
Zip	:	91208-1402
Country	:	US
Telephone Number	:	818-790-8511
Fax Number	:	818-790-8513

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	03/31/2021

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