Active NPI
Bruce Allen Warder, D.C.
- Chiropractor
- Reseda, CA
National Provider Identifier
1083615546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC23706
- Practice address
- 19231 Victory Blvd
Suite 556
Reseda, CA 91335-6308 - Phone
- (818) 705-4964
- Fax
- (818) 705-8619
- NPI assigned
- Aug 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC23706 | CA | Primary |
Addresses
Primary practice location
19231 Victory Blvd
Suite 556
Reseda, CA 91335-6308
Mailing address
19231 Victory Blvd
Suite 556
Reseda, CA 91335-6308
Phone (818) 705-4964
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23706 | CA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles LGBT Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Los Angeles, CA
- NPI 1225599178
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335744000000",
"number": "1083615546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19231 VICTORY BLVD",
"address_2": "SUITE 556",
"city": "RESEDA",
"state": "CA",
"postal_code": "913356308",
"telephone_number": "818-705-4964",
"fax_number": "818-705-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19231 VICTORY BLVD",
"address_2": "SUITE 556",
"city": "RESEDA",
"state": "CA",
"postal_code": "913356308",
"telephone_number": "818-705-4964",
"fax_number": "818-705-8619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDER",
"first_name": "BRUCE",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2012-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC23706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reseda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.