MEDICARE: BRUCE D APPELBAUM MD INC

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	2084P0800X	Psychiatry Physician	G69512	CA

General Provider Information

NPI Number	:	1952696965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE D APPELBAUM MD INC

Provider Business Mailing Address
First Line	:	18811 HUNTINGTON STREET
Second Line	:	SUITE 200
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6003
Country	:	US
Telephone Number	:	949-460-4973
Fax Number	:	949-864-2973

Provider Business Practice Location Address
First Line	:	18811 HUNTINGTON STREET
Second Line	:	SUITE 200
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-6003
Country	:	US
Telephone Number	:	949-460-4973
Fax Number	:	949-864-2973

Authorized Official
Title or Position	:	PROVIDER/OWNER
Name	:	BRUCE D APPELBAUM
Credential	:	MD
Telephone Number	:	949-460-4973

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	06/17/2011

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