Richard L Bruck, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

G30560 Issued in CA

Practice address

591 N 13TH Ave
Ste 3
Upland, CA 91786-4968

Phone

(909) 985-5885

Fax

(909) 920-3379

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1366448854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 N 13TH AVE",
            "address_2": "STE 3",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864968",
            "telephone_number": "909-985-5885",
            "fax_number": "909-920-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 N 13TH AVE",
            "address_2": "STE 3",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864968",
            "telephone_number": "909-985-5885",
            "fax_number": "909-920-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCK",
        "first_name": "RICHARD",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G30560",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "G30560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demarcus Brown
• Kevin Nathaniel Brown, D.D.S.
• Lisa Jo Brown, FNP-C
• Natalie Brown
• Perlena Brown
• Trannette Brunson
• Patrick J Bryan, M.D.
• Veronica Bueno
• Mary Phuong Bui
• Stephanie Bunawan

• Cardiovascular Disease Physician in Upland, CA
• Providers in Upland, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.