Individual provider Active NPI

Bruce Raymond Bush, M.D.

  • Emergency Medicine Physician
  • Glendora, CA
National Provider Identifier
1548202476
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G48195 Issued in CA
Practice address
814 Cloverview Dr
Glendora, CA 91741-1916
Phone
(562) 809-6978
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G48195 CA Primary

Addresses

Primary practice location

814 Cloverview Dr
Glendora, CA 91741-1916

Mailing address

814 Cloverview Dr
Glendora, CA 91741-1916
Phone (562) 809-6978

Other identifiers 1

IdentifierTypeStateIssuer
00G481950MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of California, a Professional Corporation Past Accepting new patients
East Valley Emergency Medical Associates, Inc Emergency Medicine PastSince May 16, 2021 Accepting new patients
Premier Emergency Physicians of California Medical Group PC Emergency Medicine Past Accepting new patients
Glendale Emergency Medical Associates, Inc Emergency Medicine Past Accepting new patients
Rainbow Basin Emergency Physicians, a Medical Corporation Emergency Medicine Past Accepting new patients
Norwalk Community Emergency Physician Group Inc Emergency Medicine Past Accepting new patients
Garfield Emergency Medical Associates, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 7

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1548202476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 CLOVERVIEW DR",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917411916",
            "telephone_number": "562-809-6978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 CLOVERVIEW DR",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917411916",
            "telephone_number": "562-809-6978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "BRUCE",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G48195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G481950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

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