Individual provider Active NPI

Yovana Graciela Bruno, MD

  • Pediatrics Physician
  • Duarte, CA
National Provider Identifier
1093876245
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A80031 Issued in CA
Practice address
1750 Huntington Dr Ste D
Duarte, CA 91010
Phone
(626) 930-1600
Fax
(626) 531-6920
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X A80031 CA
Pediatrics Physician 208000000X A80031 CA Primary

Addresses

Primary practice location

1750 Huntington Dr Ste D
Duarte, CA 91010

Mailing address

1 Via Ceramica
San Clemente, CA 92673-7012
Phone (626) 841-2574

Other practice location 1

3553 Camino Mira Costa Ste D
San Clemente, CA 92672-3512
Phone (949) 200-7737

Other identifiers 1

IdentifierTypeStateIssuer
00A800310OtherCAMEDICAL PROVIDER NUMBER

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A80031CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yovana Bruno Pediatric Care Inc. Adolescent Medicine Current Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
White Memorial Medical Center Past Accepting new patients

Locations

1701 E Cesar E Chavez Ave
Ste 306
Los Angeles, CA 90033
Phone (323) 225-2550

3553 Camino Mira Costa
Ste D
San Clemente, CA 92672
Phone (949) 200-7737

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1093876245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 VIA CERAMICA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926737012",
            "telephone_number": "626-841-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 HUNTINGTON DR STE D",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "91010",
            "telephone_number": "626-930-1600",
            "fax_number": "626-531-6920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3553 Camino Mira Costa Ste D",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926723512",
            "country_code": "US",
            "telephone_number": "949-200-7737",
            "fax_number": "949-336-1949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "YOVANA",
        "middle_name": "GRACIELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A80031",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A80031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PROVIDER NUMBER",
            "identifier": "00A800310",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duarte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.