Bruce P. Decarlo, MD, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

A034681 Issued in CA

Legal business name

BRUCE P. DECARLO, MD, INC.

Practice address

7407 N Cedar Ave
Suite 103
Fresno, CA 93720-3839

Phone

(559) 440-9904

Fax

(559) 440-9420

NPI assigned

Oct 24, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Schork

Title

Vice President

Phone

(714) 441-1242

Specialties & licenses 1

Addresses

Other names 1

• Thomas J. Purtzer, MD, Inc. Former legal business name

Tax ID family

Bruce P Decarlo MD Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Bruce P. Decarlo, MD, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Sacramento, CA
  • NPI 1801970173
  NPD tax ID
• Bruce P. Decarlo, MD, Inc.

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fullerton, CA
  • NPI 1841374105
  NPD tax ID

Locations

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215011580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 IMPERIAL HWY",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351040",
            "telephone_number": "714-441-1242",
            "fax_number": "714-441-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7407 N CEDAR AVE",
            "address_2": "SUITE 103",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203839",
            "telephone_number": "559-440-9904",
            "fax_number": "559-440-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE P. DECARLO, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHORK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-441-1242"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A034681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas J. Purtzer, MD, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• William Timothy Brox, MD
• Daniel B Brubaker, D.O.
• Jeremiah Brubaker
• Nadine Isabelle Brubaker, OD
• Bruce J Witmer, M.D., Professional Corporation
• Elizabeth J Bruce, MD
• James Michael Bruce, MD
• Kurt Frederick Brueggemann, M.D.
• Frederic Walter Bruhn, M.D.
• Samantha Fay Brummond, R1622150725

• Physical Medicine & Rehabilitation Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Physical Medicine & Rehabilitation Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.