Active NPI
Bruce Duncan Moore, D.C
- Chiropractor
- Corte Madera, CA
National Provider Identifier
1598097065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 17966
- Practice address
- 45 San Clemente Dr Ste D140
Corte Madera, CA 94925-1225 - Phone
- (415) 223-4251
- NPI assigned
- Feb 8, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 17966 | CA | Primary |
Addresses
Primary practice location
45 San Clemente Dr Ste D140
Corte Madera, CA 94925-1225
Mailing address
45 San Clemente Dr Ste D140
Corte Madera, CA 94925-1225
Phone (415) 223-4251
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17966 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265587200000",
"number": "1598097065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 SAN CLEMENTE DR STE D140",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251225",
"telephone_number": "415-223-4251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 SAN CLEMENTE DR STE D140",
"city": "CORTE MADERA",
"state": "CA",
"postal_code": "949251225",
"telephone_number": "415-223-4251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BRUCE",
"middle_name": "DUNCAN",
"name_prefix": "Dr.",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-08",
"last_updated": "2010-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "17966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corte Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.