Individual provider Active NPI

Bruce Allen Chernof, M.D.

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1023357431
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G66646 Issued in CA
Practice address
3800 Kilroy Airport Way
The Scan Foundation, Suite 400
Long Beach, CA 90806-2494
Phone
(562) 308-2858
Fax
(562) 308-2707
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G66646 CA Primary

Addresses

Primary practice location

3800 Kilroy Airport Way
The Scan Foundation, Suite 400
Long Beach, CA 90806-2494

Mailing address

3800 Kilroy Airport Way
The Scan Foundation, Suite 400
Long Beach, CA 90806-2494
Phone (562) 308-2858

Other identifiers 1

IdentifierTypeStateIssuer
G66646OtherCAPHYSICIANS AND SURGEONS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G66646CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023357431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY",
            "address_2": "THE SCAN FOUNDATION, SUITE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062494",
            "telephone_number": "562-308-2858",
            "fax_number": "562-308-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY",
            "address_2": "THE SCAN FOUNDATION, SUITE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062494",
            "telephone_number": "562-308-2858",
            "fax_number": "562-308-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNOF",
        "first_name": "BRUCE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G66646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS AND SURGEONS LICENSE",
            "identifier": "G66646",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.