Mark Neil Bruckner, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G50614 Issued in CA

Practice address

2876 Sycamore Dr
Suite 302
Simi Valley, CA 93065-1550

Phone

(805) 522-4400

NPI assigned

Sep 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Los Robles Regional Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1033163019
  NPD (past)
• Simi Valley Hospital and Health Care Services

  • General Acute Care Hospital
  • Simi Valley, CA
  • NPI 1063495190
  NPD (past)

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245226232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2668 VIA ZURITA CT",
            "city": "SANTA ROSA VALLEY",
            "state": "CA",
            "postal_code": "930129336",
            "telephone_number": "805-491-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2876 SYCAMORE DR",
            "address_2": "SUITE 302",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651550",
            "telephone_number": "805-522-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "MARK",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G50614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooks, Tashman, Medical Corporation
• Carole Lee Brookshire, MFT 115869
• Nicole Christine Brown, IBCLC
• Nicolette Brown, MT-BC
• Rebecca L Brown, MS CCC SLP
• Richard Bruckner, D.D.S.
• Taya Lynn Bruininga
• Susan Bruno, D.C.
• Amanda Brusca
• Barry Evan Bubar, D.D.S.

• Pediatrics Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.