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NPI Code Detail

MEDICARE: DR. BRUCE S VICTOR M.D.

MEDICARE:  DR. BRUCE S VICTOR  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
12084P0800XPsychiatry PhysicianG46245CA

General Provider Information

NPI Number : 1861571713
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRUCE S VICTOR M.D.
Provider Business Mailing Address
First Line : 1819 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4307
Country : US
Telephone Number : 415-346-7025
Fax Number : 415-346-0931
Provider Business Practice Location Address
First Line : 1819 UNION ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94123-4307
Country : US
Telephone Number : 415-346-7025
Fax Number : 415-346-0931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 07/08/2007

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Directions to “ DR. BRUCE S VICTOR M.D.” Practice Location

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